| NPI | 1558607226 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JABRIEL ROSE President And Treasurer 847-224-5282 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071.007542) |
| Enumeration Date | 2012-12-27 |
| Last Update Date | 2012-12-27 |