NPI | 1629391776 |
---|---|
Entity Type | Organization |
Authorized Contact | MARK DAVE BERGER President 312-782-0292 |
Organization Subpart ? | No |
Primary Taxonomy | 102L00000X Psychoanalyst (Licence: IL 042.000349036.033630) |
Additional Taxonomies | 102L00000X Psychoanalyst (Licence: IL 3636630) |
Enumeration Date | 2010-03-03 |
Last Update Date | 2010-04-14 |