| NPI | 1982876116 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WAYNE PREPURA President 847-680-3828 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: IL 071002565) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: IL 6393) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: IL 6392) | |
| 101YP2500X Counselor Professional (Licence: IL 180001252) | |
| 103T00000X Psychologist (Licence: IL 071002565) | |
| Enumeration Date | 2008-03-27 |
| Last Update Date | 2016-10-20 |