| NPI | 1598161432 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLIE A RHODES-GAYLES President/Owner 773-233-1900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019023222) |
| Enumeration Date | 2014-11-04 |
| Last Update Date | 2014-11-04 |