| NPI | 1336415611 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH WALLACH Licensed Clinical Psychologist 773-852-2400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071007942) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: IL 071007942) |
| 103TH0004X Psychologist, Health (Licence: IL 071007942) | |
| Enumeration Date | 2012-03-30 |
| Last Update Date | 2012-03-30 |