| NPI | 1801022256 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM M. KELLY Orthodontist/Owner 630-584-9666 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IL 019013853) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IL 019026074) |
| Enumeration Date | 2009-05-29 |
| Last Update Date | 2009-05-29 |