| NPI | 1861907297 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI J NEWMAN Office Administrator 708-560-6653 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071009258) |
| Enumeration Date | 2017-12-07 |
| Last Update Date | 2017-12-07 |