| NPI | 1649310913 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY MICHAEL TRONC Director 815-899-0501 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical |
| Additional Taxonomies | 103T00000X Psychologist |
| 1041C0700X Social Worker Clinical | |
| 235Z00000X Speech-Language Pathologist | |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2007-07-24 |