| NPI | 1912153156 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHEILA R MORIARTY Business Administrator 630-377-1010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019A020460) |
| Enumeration Date | 2008-08-07 |
| Last Update Date | 2008-08-07 |