| NPI | 1265667935 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDY GEORGEMILLER President 847-913-5175 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071003110) |
| Enumeration Date | 2009-05-23 |
| Last Update Date | 2013-09-05 |