| NPI | 1871797308 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NASRIN AZIMZADEH Owner 847-296-3200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019024883) |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2008-05-14 |