| NPI | 1790226207 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS ROBERT UNDINE Owner 773-732-7700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149.013059) |
| Enumeration Date | 2017-03-16 |
| Last Update Date | 2017-03-16 |