| NPI | 1316355399 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELYSIA AN President 630-851-5250 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019026799) |
| Enumeration Date | 2014-07-23 |
| Last Update Date | 2014-07-23 |