| NPI | 1407003437 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNA M PELAK CEO 847-358-2477 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019020825) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: IL 019020825) |
| 1223P0300X Dentist, Periodontics (Licence: IL 019020825) | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IL 019020825) | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IL 019020825) | |
| Enumeration Date | 2008-08-21 |
| Last Update Date | 2008-08-21 |