NPI | 1497819759 |
---|---|
Entity Type | Organization |
Authorized Contact | JOHN MCNERNEY Dentist 847-550-0700 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019-021306) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019-022090) |
Enumeration Date | 2006-12-21 |
Last Update Date | 2020-08-22 |