| NPI | 1407022536 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONA MANN Insurance Coordinator 773-548-0600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IL 019019459) |
| Enumeration Date | 2008-05-08 |
| Last Update Date | 2014-04-07 |