| NPI | 1801298856 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAIME CUSHING President 773-248-8836 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IL 019.027354) |
| Enumeration Date | 2014-09-22 |
| Last Update Date | 2014-09-22 |