| NPI | 1922766526 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDALL SUMMERVILLE Owner 630-424-8900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| Enumeration Date | 2021-12-01 |
| Last Update Date | 2022-12-05 |