| NPI | 1497174882 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JADA JOHNSON Manager 773-991-0768 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036123239) |
| Enumeration Date | 2014-04-14 |
| Last Update Date | 2014-04-14 |