| NPI | 1679546873 |
|---|---|
| Former Legal Business Name | PRA PSYCHIATRIC GROUP |
| Entity Type | Organization |
| Authorized Contact | PAULA MAZLIACH COMM Practice Administrator 847-240-2211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| 1041C0700X Social Worker, Clinical | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry | |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2018-09-04 |