| NPI | 1780802223 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALD G. GUTSELL President 773-763-0433 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IL 019.016356) |
| Enumeration Date | 2007-04-22 |
| Last Update Date | 2020-08-22 |