| NPI | 1023345568 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN M HANSEN Sole Member 630-837-3700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: IL 019019366) |
| Enumeration Date | 2009-11-04 |
| Last Update Date | 2009-11-04 |