| NPI | 1619163367 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARL E HENLEY Owner 630-357-9393 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019018806) |
| Enumeration Date | 2007-09-17 |
| Last Update Date | 2017-03-14 |