| NPI | 1487862561 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA C. RACEAN Owner 847-329-7901 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019023622) |
| Enumeration Date | 2007-05-20 |
| Last Update Date | 2020-08-22 |