| NPI | 1710154679 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER RANDOLPH Director 312-863-3033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071004821) |
| Enumeration Date | 2008-05-09 |
| Last Update Date | 2008-05-09 |