| NPI | 1669806873 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH HALVORSON Coordinator 312-283-2650 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071.004492) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IL 1265773659) |
| 106H00000X Marriage & Family Therapist (Licence: IL 071.004492) | |
| 133V00000X Dietitian, Registered (Licence: IL 164.005161) | |
| Enumeration Date | 2013-08-23 |
| Last Update Date | 2013-08-23 |