| NPI | 1083760987 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARL B. CONRAD Pres. 630-963-7767 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IL 14280) |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2020-08-22 |