| NPI | 1275324899 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW CARBONELLI Licensed Psychologist 224-523-4236 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2025-05-14 |
| Last Update Date | 2025-08-13 |