| NPI | 1508146580 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REEM OBAISI President 217-871-0411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019027619) |
| Enumeration Date | 2011-08-23 |
| Last Update Date | 2011-08-23 |