| NPI | 1386299675 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOVEL BROQUEZA Administrator 630-344-9617 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry |
| Additional Taxonomies | 261QM1300X Clinic/Center Multi-Specialty |
| Enumeration Date | 2019-08-05 |
| Last Update Date | 2024-10-01 |