| NPI | 1609322791 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE THERESE BUBECK Owner/President 630-369-5645 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: IL 166.000604) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: IL 164.001456) |
| Enumeration Date | 2016-08-29 |
| Last Update Date | 2016-08-29 |