| NPI | 1174991905 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANELLE MARCHESE Dentist 630-220-8401 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019030388) |
| Enumeration Date | 2015-09-10 |
| Last Update Date | 2015-09-10 |