| NPI | 1881392678 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY LIPSON President/Chief Clinical Officer 847-329-9210 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Enumeration Date | 2023-02-21 |
| Last Update Date | 2023-08-29 |