| NPI | 1679772479 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIROSLAW JAN WALO President 847-324-4300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TP0016X Psychologist, Prescribing (Medical) (Licence: IL 042618878) |
| Enumeration Date | 2007-07-12 |
| Last Update Date | 2017-03-29 |