| NPI | 1396283768 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TETYANA KOSTYSHYNA Psychologist, Manager 312-818-9300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2017-02-06 |
| Last Update Date | 2021-10-13 |