| NPI | 1255078119 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GABRIELLE L WOLK-PHILLIPS Licensed Clinical Psychologist 847-612-9477 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Enumeration Date | 2022-05-12 |
| Last Update Date | 2022-05-12 |