| NPI | 1629478599 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI A SMITH Practice Manager 847-816-6441 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology |
| Additional Taxonomies | 103T00000X Psychologist |
| 1041C0700X Social Worker Clinical | |
| 2084P0800X Psychiatry & Neurology Psychiatry | |
| 363A00000X Physician Assistant | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| Enumeration Date | 2014-08-28 |
| Last Update Date | 2025-01-17 |