| NPI | 1336295757 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIRK WAYNE ERICKSON President 847-604-0734 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071004736) |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2011-01-20 |