NPI | 1821151135 |
---|---|
Entity Type | Organization |
Authorized Contact | DAVID R. JEZL Executive Director 847-884-0210 |
Organization Subpart ? | No |
Primary Taxonomy | 103TC0700X Psychologist Clinical |
Additional Taxonomies | 101YP2500X Counselor Professional |
103G00000X Clinical Neuropsychologist | |
Enumeration Date | 2006-12-18 |
Last Update Date | 2015-02-26 |