| NPI | 1346642600 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA L. BECKER Doctor 847-364-0661 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019026149) |
| Enumeration Date | 2014-09-18 |
| Last Update Date | 2014-09-18 |