| NPI | 1356664973 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEE L MADDEN Clinical Psychologist 708-383-0729 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: IL 071006523) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: 149009982) |
| 1041C0700X Social Worker Clinical (Licence: IL 149003610) | |
| Enumeration Date | 2010-03-10 |
| Last Update Date | 2010-03-10 |