| NPI | 1497194070 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUZANNE WAHL Practice Manager 847-668-4295 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149009042) |
| Enumeration Date | 2013-06-18 |
| Last Update Date | 2022-12-21 |