| NPI | 1922188986 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA MICHELLE BACON President 773-350-7717 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036095103) |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2020-08-22 |