| NPI | 1972641785 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINE M MICHAELS Orthodontist 630-851-5191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019022546) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: IL 021001702) |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2020-08-22 |