| NPI | 1528222932 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA SPANNAGEL Business Coordinator 847-259-4244 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019020217) |
| Enumeration Date | 2008-07-15 |
| Last Update Date | 2008-09-09 |