| NPI | 1801102124 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HENRY SHARFAEI Owner 630-904-4444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019023174) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019023095) |
| 1223G0001X Dentist, General Practice (Licence: IL 019027028) | |
| 1223G0001X Dentist, General Practice (Licence: IL 019020397) | |
| 1223G0001X Dentist, General Practice (Licence: IL 019025309) | |
| 1223G0001X Dentist, General Practice (Licence: IL 019018724) | |
| 1223G0001X Dentist, General Practice (Licence: IL 019026761) | |
| 1223P0300X Dentist, Periodontics (Licence: IL 021001093) | |
| 1223P0300X Dentist, Periodontics (Licence: IL 021002284) | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IL 021001165) | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IL 021001475) | |
| Enumeration Date | 2010-08-24 |
| Last Update Date | 2016-04-21 |