| NPI | 1679014062 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA SANCHEZ Front Desk Coordinator 847-520-3020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IL 019.026125) |
| Enumeration Date | 2017-03-17 |
| Last Update Date | 2017-03-17 |