| NPI | 1700902491 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WALTER DONALD HEINLEIN President 847-729-4411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 060000271) |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2008-04-17 |