| NPI | 1861550733 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL F. CHIAPPETTA Clinic Director 847-695-7512 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 71749) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IL 149001441) |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2020-08-22 |