| NPI | 1972823433 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN MARY PETERMAN Office Manager 847-255-5552 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019020252) |
| Enumeration Date | 2010-06-08 |
| Last Update Date | 2010-06-08 |