| NPI | 1023316098 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN ROBERT THODOS President 847-458-1437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IL 021.001229) |
| Enumeration Date | 2011-03-01 |
| Last Update Date | 2011-03-01 |