| NPI | 1811216146 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN J WIBICKI President 847-458-4758 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019021866) |
| Enumeration Date | 2010-05-26 |
| Last Update Date | 2010-05-26 |