| NPI | 1457448680 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHRYN SEIDEL Business Manager 312-829-4208 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 060-000213) |
| Enumeration Date | 2006-10-09 |
| Last Update Date | 2020-08-22 |