| NPI | 1902957962 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN L. CARNEY Clinical Director 773-852-1780 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) | |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2008-01-03 |