| NPI | 1760563688 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDY JOHN JUNG Owner 618-235-1582 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036085990) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2020-08-22 |