| NPI | 1861602054 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS PAUL SELVIG Managing Director 847-441-2399 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071004066) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2020-08-22 |