| NPI | 1659086809 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHEILA MOFFETT Office Administrator 773-316-2317 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| Enumeration Date | 2023-01-20 |
| Last Update Date | 2023-01-20 |