| NPI | 1215465893 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOUISE MOORE President 847-477-7502 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) |
| 103TC0700X Psychologist, Clinical | |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| 103TF0000X Psychologist, Family | |
| 1041C0700X Social Worker, Clinical | |
| 207Q00000X Family Medicine | |
| 207QA0401X Family Medicine, Addiction Medicine | |
| 207R00000X Internal Medicine | |
| 207RA0401X Internal Medicine, Addiction Medicine | |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry | |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| 364SP0808X Clinical Nurse Specialist, Psych/Mental Health | |
| Enumeration Date | 2017-05-26 |
| Last Update Date | 2021-07-21 |