| NPI | 1881266229 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON EDWARD LAHOOD Director Of Clinical Services 312-659-0020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Enumeration Date | 2021-07-14 |
| Last Update Date | 2024-10-09 |