| NPI | 1801194527 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH GILL Administrator 708-756-1700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 207Q00000X Family Medicine | |
| 2083X0100X Preventive Medicine, Occupational Medicine | |
| Enumeration Date | 2011-03-03 |
| Last Update Date | 2011-09-27 |