| NPI | 1811063662 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN A JAESCHKE President 630-355-0100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IL 019019478) |
| Enumeration Date | 2006-11-24 |
| Last Update Date | 2020-08-22 |