| NPI | 1740359991 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES PETER ECONOMOS Owner 630-830-4930 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 19016838IL) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: IL 19016838IL) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IL 19016838IL) | |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2020-08-22 |