| NPI | 1639263197 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BERNADETTE GOHEEN KOHN President 815-344-0020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: IL 00303608454) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036083810) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2020-08-22 |