| NPI | 1679198055 |
|---|---|
| Former Legal Business Name | DITCHEK PSYCHOLOGICAL SERVICES, PLLC |
| Entity Type | Organization |
| Authorized Contact | LISA DITCHEK Manager 847-390-0800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Enumeration Date | 2020-06-11 |
| Last Update Date | 2020-06-11 |