| NPI | 1760850291 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN KLOBERDANZ President 630-377-7077 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: IL 021001535) |
| Enumeration Date | 2015-09-15 |
| Last Update Date | 2015-09-15 |