| NPI | 1619004363 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN JON RICHARDSON Psychologist 847-222-0793 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071004102) |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2010-10-28 |