| NPI | 1821391442 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDY L MARRINER Credentialing Manager 630-912-4241 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036083961) |
| Enumeration Date | 2010-12-21 |
| Last Update Date | 2025-01-17 |