| NPI | 1457570459 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID LOPEZ ROQUE President 773-271-3344 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry |
| Additional Taxonomies | 208D00000X General Practice |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2020-08-22 |