| NPI | 1235100140 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL JAMES ATHANS Director 847-823-4444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071003398) |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2011-11-08 |