| NPI | 1538350533 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALD M DONNELLI Owner 815-877-4300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019017607) |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2007-08-05 |