| NPI | 1447634837 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NISHA SHAH Therapist 224-565-4420 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IL 180.007138) |
| Enumeration Date | 2015-07-15 |
| Last Update Date | 2015-07-15 |