| NPI | 1205882313 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FREDERICK WILBURN BYLSMA Owner, President 847-738-4528 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist |
| Additional Taxonomies | 103TA0700X Psychologist Adult Development & Aging |
| 103TB0200X Psychologist Cognitive & Behavioral | |
| 103TC0700X Psychologist Clinical | |
| 103TC1900X Psychologist Counseling | |
| 103TC2200X Psychologist Clinical Child & Adolescent | |
| 103TF0000X Psychologist Family | |
| 103TF0200X Psychologist Forensic | |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2015-03-09 |