| NPI | 1962696054 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH FLEEGE Practice Manager 847-301-4333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2007-08-31 |
| Last Update Date | 2025-08-06 |