| NPI | 1902915986 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN M. MAZZEI President/CEO 630-393-3045 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: IL 019-021039) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2022-06-07 |