| NPI | 1790909513 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHOEBE VAN HAM Therapist 630-260-1166 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149001872) |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2008-06-13 |