| NPI | 1457870388 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN KOMPERDA Clinical Professional Counselor 708-715-8448 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IL 180.010660) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 32003) |
| 102L00000X Psychoanalyst (Licence: IL 180.010660) | |
| Enumeration Date | 2017-09-12 |
| Last Update Date | 2017-09-12 |