| NPI | 1710008370 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUBINA NGUYEN Secretary 847-854-0525 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019025559) |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2013-07-16 |