| NPI | 1356205538 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARIN VANDER PLOEG BOOTH Owner 773-636-6975 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics |
| Enumeration Date | 2025-12-12 |
| Last Update Date | 2025-12-12 |