| NPI | 1508168105 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE MIGUEL President 815-744-8253 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036098565) |
| Enumeration Date | 2010-12-02 |
| Last Update Date | 2010-12-02 |