| NPI | 1912719584 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MITCH SCHWARZ Director 224-777-8036 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2025-01-22 |
| Last Update Date | 2025-04-11 |