| NPI | 1336505171 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | A. KHAN Staff 847-895-0000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019.025459) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019.024689) |
| Enumeration Date | 2016-01-09 |
| Last Update Date | 2016-02-18 |