| NPI | 1841065109 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MINA KHAROT PAIMAN Medical Director 773-970-6700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| 2084P0005X Psychiatry & Neurology Neurodevelopmental Disabilities | |
| 261QD1600X Clinic/Center Developmental Disabilities | |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| Enumeration Date | 2023-11-16 |
| Last Update Date | 2023-11-16 |