| NPI | 1003092800 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY W. CHANDLER President 312-636-5775 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IL 019026314) |
| Enumeration Date | 2008-01-11 |
| Last Update Date | 2008-02-13 |