| NPI | 1942454368 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GAURAV ASHOK PATEL Doctor 847-885-8780 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019024608) |
| Additional Taxonomies | 122300000X Dentist (Licence: IL 019024898) |
| Enumeration Date | 2008-11-12 |
| Last Update Date | 2008-11-12 |