| NPI | 1881936540 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANA WHITE Office Manager 847-299-3365 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019021756) |
| Enumeration Date | 2013-03-20 |
| Last Update Date | 2013-03-20 |