| NPI | 1770888703 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLGA GREEN Clinical Director 847-494-0126 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IL 071.007850) |
| 103TP0016X Psychologist, Prescribing (Medical) | |
| Enumeration Date | 2011-01-23 |
| Last Update Date | 2023-04-19 |