| NPI | 1902599640 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHANIEL ISAAC Owner 630-936-8747 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2023-05-30 |
| Last Update Date | 2023-05-30 |