| NPI | 1649913658 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH MALCOLM Nurse Pratctitioner 630-216-9191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2022-04-18 |
| Last Update Date | 2022-04-18 |