| NPI | 1235243510 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTIN J FIELDS Psychiatrist 815-633-5985 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 036044184) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IL 071006307) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2012-03-13 |