| NPI | 1902130339 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHYLLIS REMER Billing Mgr 847-433-0057 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: IL 036109024) |
| Additional Taxonomies | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: IL 036113400) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: IL 036111615) | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: IL 036118379) | |
| Enumeration Date | 2009-10-02 |
| Last Update Date | 2009-11-23 |