| NPI | 1891028460 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP EDWARD LANE President 312-953-0866 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036-030074) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 036-051264) |
| Enumeration Date | 2009-09-14 |
| Last Update Date | 2009-09-14 |