| NPI | 1053600791 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE S. PANOS President 630-650-2428 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: IL 019022207) |
| Enumeration Date | 2011-04-04 |
| Last Update Date | 2011-04-04 |