Provider Type Icon

HIGHLAND PARK OMS NPI 1912283730


NPI Information

NPI: 1912283730
Provider Name: HIGHLAND PARK OMS
Classification: Dentist - 1223S0112X
Entity Type: Organization

Specialization: Oral and Maxillofacial Surgery

Address:
1893 SHERIDAN RD
SUITE 311
HIGHLAND PARK, IL
ZIP 60035
Phone: (847) 433-6636
Get Directions

HIGHLAND PARK OMS is an oral and maxillofacial surgery dentist in Highland Park, 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. HIGHLAND PARK OMS NPI is 1912283730. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1893 SHERIDAN RD
SUITE 311
HIGHLAND PARK, IL
ZIP 60035-628
Phone: (847) 433-6636
Fax: (847) 433-2090

The provider's authorized official is Mark B Jacob .
The authorized official title is Owner and has the following contact phone number (847) 433-6636.

The enumeration date for this NPI number is 10/25/2011 and was last updated on 10/25/2011.


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 Surgery019022948ILLINOISNo
21223S0112XDentistOral and Maxillofacial Surgery021002059ILLINOISYes

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.