| NPI | 1629181243 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK SHUKHMAN Gen Partner 224-217-9019 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry |
| 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry | |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2009-11-21 |