| NPI | 1578980876 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXANDER M TIMCHAK Manager 708-207-4580 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 336090545) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: IL 336090545) |
| Enumeration Date | 2014-03-25 |
| Last Update Date | 2014-03-25 |