| NPI | 1932578234 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOOMAN KESHAVARZI Executive Director 224-622-3116 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071007457) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 178.010934) |
| 101YP2500X Counselor, Professional (Licence: IL 180.008541) | |
| 101YP2500X Counselor, Professional (Licence: IL 180009783) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: IL 036093319) | |
| Enumeration Date | 2015-09-17 |
| Last Update Date | 2015-09-23 |