NPI | 1548501570 |
---|---|
Entity Type | Organization |
Authorized Contact | JANE CONRON Licensed Clinical Psychologist/Owne 773-859-1718 |
Organization Subpart ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071004750) |
Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: IL 071004750) |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: IL 071004570) | |
103TF0000X Psychologist, Family (Licence: IL 071004750) | |
103TH0004X Psychologist, Health (Licence: IL 071004750) | |
Enumeration Date | 2013-03-15 |
Last Update Date | 2013-03-15 |