NPI | 1427435056 |
---|---|
Entity Type | Organization |
Authorized Contact | MUMTAZ SIDDIQUE Doctor 815-943-7709 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IL 019022632) |
Enumeration Date | 2015-05-04 |
Last Update Date | 2015-05-04 |