| NPI | 1265737258 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERRIE LYNN WEBER Clinical Professional Couselor 773-654-2420 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071006768) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 201663803) |
| Enumeration Date | 2011-01-21 |
| Last Update Date | 2011-01-21 |