| NPI | 1598189201 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICARDO G TAPIADOR Dentist 847-662-2121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: IL 19-A15676) |
| Enumeration Date | 2014-02-17 |
| Last Update Date | 2014-02-17 |