| NPI | 1619156528 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT M. SHOLTES Authorized Official 847-328-1920 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036084101) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IL 149005971) |
| Enumeration Date | 2007-10-26 |
| Last Update Date | 2007-10-26 |