| NPI | 1578001830 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER R POTTORFF President 847-854-1200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019.024833) |
| Enumeration Date | 2017-02-07 |
| Last Update Date | 2019-03-01 |