| NPI | 1073849139 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES G LOESER CEO 847-390-8200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: IL 036121553) |
| Enumeration Date | 2009-10-26 |
| Last Update Date | 2009-10-26 |