| NPI | 1588905897 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ILYAS AHMED Dentist 773-486-6500 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019026721) |
| Enumeration Date | 2013-03-12 |
| Last Update Date | 2013-03-12 |