| NPI | 1679711642 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN L GYOERKOE Member 773-220-1995 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071.006130) |
| Enumeration Date | 2009-01-29 |
| Last Update Date | 2009-01-29 |