| NPI | 1386016731 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUBINA NGUYEN Owner 847-854-0525 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019.025559) |
| Enumeration Date | 2015-10-26 |
| Last Update Date | 2022-07-21 |