| NPI | 1932767803 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALAN WEISSMAN Practice Manager 847-423-2625 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-06-04 |
| Last Update Date | 2019-06-11 |