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GRAYSLAKE ORAL AND MAXILLOFACIAL SURGERY NPI 1871767780


NPI Information

NPI: 1871767780
Provider Name: GRAYSLAKE ORAL AND MAXILLOFACIAL SURGERY
Classification: Dentist - 1223S0112X
Entity Type: Organization

Specialization: Oral and Maxillofacial Surgery

Address:
115 COMMERCE DR
SUITE D
GRAYSLAKE, IL
ZIP 60030
Phone: (847) 548-8800
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GRAYSLAKE ORAL AND MAXILLOFACIAL SURGERY is an oral and maxillofacial surgery dentist in Grayslake, IL. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. GRAYSLAKE ORAL AND MAXILLOFACIAL SURGERY NPI is 1871767780. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

115 COMMERCE DR
SUITE D
GRAYSLAKE, IL
ZIP 60030-812
Phone: (847) 548-8800
Fax: (847) 548-8802

The provider's authorized official is Jeffrey Marlin Babiuk .
The authorized official title is President and has the following contact phone number (847) 548-8800.

The enumeration date for this NPI number is 4/22/2008 and was last updated on 4/22/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223S0112XDentistOral and Maxillofacial Surgery019-022879ILLINOISYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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