| NPI | 1467505503 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT A WATSON Director 847-275-7706 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 71004730) |
| Enumeration Date | 2007-01-20 |
| Last Update Date | 2020-08-22 |