| NPI | 1285773945 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM SIMON President 773-663-3800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: IL 19018557) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2020-08-22 |