| NPI | 1952767808 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE CLARKE Clinic Director 312-996-3535 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: IL 019.029461) |
| Enumeration Date | 2016-01-07 |
| Last Update Date | 2016-01-07 |