| NPI | 1891887956 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK L BANAKIS Oral Surgeon 847-882-9448 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IL 021001611 Dr Banakis) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: IL 021000892 Dr Doepfle) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2016-10-19 |