| NPI | 1548697618 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SEMONE WEST Member 312-208-9741 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: IL 036111615) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology Addiction Medicine (Licence: IL 036126914) |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: IL 036111615) | |
| Enumeration Date | 2013-10-03 |
| Last Update Date | 2023-05-19 |