| NPI | 1720132806 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA ANN ROOS Billing Manager 630-541-5040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WI 1598-057) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2014-01-29 |