| NPI | 1629377882 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JON-PAUL CHAMPINE President 847-869-4650 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: IL 071006739) |
| Enumeration Date | 2011-03-26 |
| Last Update Date | 2011-03-26 |