| NPI | 1992051130 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE R MYERS Owner 773-972-4248 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: IL 071007744) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IL 071007744) |
| Enumeration Date | 2012-07-25 |
| Last Update Date | 2013-11-01 |