| NPI | 1235430612 |
|---|---|
| Doing Business As | PORTRAIT HEALTH CENTERS |
| Entity Type | Organization |
| Authorized Contact | JEREMY WARNER Practice Manager 847-868-3435 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: IL 071007099) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: IL 164005333) |
| Enumeration Date | 2010-11-16 |
| Last Update Date | 2013-09-06 |