| NPI | 1912062969 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD R CHAVEZ President 630-510-0731 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019017516) |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2012-05-31 |