| NPI | 1215982509 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RALPH MENEZES Provider/Owner 708-488-4968 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: IL 036054796) |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2015-04-21 |