| NPI | 1205552213 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAYAL K SHAH Owner 773-957-5435 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| 261QM0801X | |
| Enumeration Date | 2022-10-12 |
| Last Update Date | 2022-10-12 |