| NPI | 1720385594 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFERY J KORKUS Owner 312-860-4001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019028282) |
| Enumeration Date | 2011-02-14 |
| Last Update Date | 2011-02-14 |