| NPI | 1609243856 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON E LAHOOD Director Of Clinical Services 312-659-0020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071008046) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: IL 071008046) |
| Enumeration Date | 2015-08-24 |
| Last Update Date | 2015-08-24 |