| NPI | 1669735767 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAILEE SHASHI PATEL President 312-217-4490 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019.027415) |
| Enumeration Date | 2012-06-22 |
| Last Update Date | 2017-02-28 |