| NPI | 1770931602 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH HALVORSON Director Of Clinical Services 312-283-2650 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071004492) |
| Enumeration Date | 2016-06-01 |
| Last Update Date | 2016-06-01 |