| NPI | 1598814154 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA J HEALY Office Manager 773-772-7373 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: IL 019023892) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2020-08-22 |