| NPI | 1407095466 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL STUART BLACK President 847-835-5517 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071-000739) |
| Enumeration Date | 2009-02-16 |
| Last Update Date | 2009-02-16 |