| NPI | 1316203896 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY DAVID KAZMIERCZAK Psychologist 773-412-2778 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist |
| Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging |
| 103TC0700X Psychologist, Clinical | |
| 103TC1900X Psychologist, Counseling | |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| 103TR0400X Psychologist, Rehabilitation (Licence: IL 071008293) | |
| Enumeration Date | 2012-04-09 |
| Last Update Date | 2012-11-15 |