| NPI | 1982906590 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUE WEIS Office Manager 630-388-5360 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019018724) |
| Enumeration Date | 2010-12-02 |
| Last Update Date | 2010-12-02 |