| NPI | 1437104403 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH M BOLASH Psychologist 847-259-2020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: IL 071-006831) |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2020-08-22 |