| NPI | 1265668297 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY A. LEMKE Provider 847-903-7916 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: IL 071006999) |
| Enumeration Date | 2009-06-04 |
| Last Update Date | 2009-06-05 |