| NPI | 1801268305 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANICE A LUBAS Secretary 708-424-1300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: IL 019020526) |
| Enumeration Date | 2015-10-22 |
| Last Update Date | 2015-10-23 |