| NPI | 1598946881 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK JOSEPH HUMENIK President 847-272-5400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IL 019021348) |
| Enumeration Date | 2007-11-15 |
| Last Update Date | 2007-11-15 |