| NPI | 1174612451 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY TODD COHEN President 847-680-7171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IL 019-021869) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: IL 019-021869) |
| 1223P0300X Dentist, Periodontics (Licence: IL 019-021869) | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IL 019-021869) | |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2025-09-11 |