| NPI | 1366655813 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLAN L. BOTKIN Director 847-680-0279 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071-003239) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2020-08-22 |