| NPI | 1396856134 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK IRA BORNSTEIN Owner President 708-461-2333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071004534) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2009-10-06 |