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 |