| NPI | 1760665442 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEANN DERRICO Business Administrator 630-983-8700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019-019814) |
| Enumeration Date | 2007-12-17 |
| Last Update Date | 2018-04-10 |