| NPI | 1013048297 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA GILLERAN Dentist 312-368-8771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019020008) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2020-08-22 |