| NPI | 1003993742 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY M HANSEN General Dentist 630-837-3700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019019366) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2020-08-22 |