| NPI | 1245319607 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARRY F FREYDBERG President 847-673-7118 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019-013115) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019-013408) |
| 1223G0001X Dentist, General Practice (Licence: IL 019-013513) | |
| 1223G0001X Dentist, General Practice (Licence: IL 019-022789) | |
| 1223G0001X Dentist, General Practice (Licence: IL 019-026122) | |
| 1223G0001X Dentist, General Practice (Licence: IL 019-025127) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: IL 021-001997) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: IL 021-001255) | |
| 1223P0300X Dentist, Periodontics (Licence: IL 021-001463) | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IL 021-000726) | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IL 021-000601) | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IL 021-001066) | |
| Enumeration Date | 2006-11-04 |
| Last Update Date | 2020-08-22 |