| NPI | 1346840659 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURIE GUAGENTI Credentialing COO Rdinator 312-480-5186 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry |
| Enumeration Date | 2020-10-27 |
| Last Update Date | 2020-10-27 |