| NPI | 1679146989 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAQUEL TORRES Billing Manager 224-970-2208 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor, Mental Health | |
| 101YP2500X Counselor, Professional | |
| 103T00000X Psychologist | |
| 103TC0700X Psychologist, Clinical | |
| 103TC1900X Psychologist, Counseling | |
| 103TP2701X Psychologist, Group Psychotherapy | |
| 104100000X Social Worker | |
| 1041C0700X Social Worker, Clinical | |
| 163W00000X Registered Nurse | |
| 207R00000X Internal Medicine | |
| 2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry | |
| 364SP0809X Clinical Nurse Specialist, Psych/Mental Health, Adult | |
| Enumeration Date | 2021-07-23 |
| Last Update Date | 2025-08-25 |