| NPI | 1760575914 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER E SMITH Credentialing Agent 815-965-8505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036105570) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2016-05-10 |