| NPI | 1982190633 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA NOVAK Manager/Clinical Psychologist 312-857-6393 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IL 071009040) |
| Enumeration Date | 2018-07-05 |
| Last Update Date | 2018-07-05 |