| NPI | 1952969412 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE L RANDALL Licensed Clinical Psychologist 847-446-7636 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Enumeration Date | 2019-05-30 |
| Last Update Date | 2024-07-18 |