| NPI | 1659531549 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER SMITH Credentialing Agent 815-965-8505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036076824) |
| Enumeration Date | 2008-06-13 |
| Last Update Date | 2008-06-13 |