| NPI | 1750036331 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHELSEA COOPER Managing Partner 847-220-4365 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-02-13 |
| Last Update Date | 2024-01-03 |