| NPI | 1720622624 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FAAN YEEN SIDOR President 847-431-1722 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2019-11-04 |
| Last Update Date | 2019-11-04 |