| NPI | 1912190901 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARL M WAHLSTROM President 312-782-7895 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036-076654) |
| Enumeration Date | 2007-08-22 |
| Last Update Date | 2007-08-22 |