| NPI | 1588433502 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDY MARRINER Credentialing Manager 630-912-4241 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2024-01-02 |
| Last Update Date | 2024-08-08 |