| NPI | 1417100991 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BONNIE E GERSHENZON Psychotherapist 847-480-9671 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071.003586) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IL LCSW149005279) |
| 1041C0700X Social Worker, Clinical (Licence: IL LCSW149000197) | |
| Enumeration Date | 2008-10-29 |
| Last Update Date | 2008-10-29 |