| NPI | 1215153853 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NEIL R. BOCKIAN Clinical Psychologist 773-710-3493 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TA0700X Psychologist Adult Development & Aging (Licence: IL 071-005194) |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2018-06-21 |