| NPI | 1285182121 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE M WELBEL Clinical Psychologist 847-571-7726 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071008625) |
| Enumeration Date | 2016-09-20 |
| Last Update Date | 2016-09-20 |