| NPI | 1437495249 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCIA NICKOW Owner Private Practitioner 847-244-9772 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071008022) |
| Enumeration Date | 2012-12-26 |
| Last Update Date | 2012-12-26 |