| NPI | 1225425713 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN KERZMAN Clinical Director 773-332-7832 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: IL 071008860) |
| Enumeration Date | 2015-04-22 |
| Last Update Date | 2015-07-27 |