North Suburban Oral Surgery, LTD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

NORTH SUBURBAN ORAL SURGERY, LTD

Doing business as

North Suburban Center for Oral & Facial Surgery

Practice address

1240 Meadow Rd
Suite 300
Northbrook, IL 60062-8300

Phone

(847) 272-9516

Fax

(847) 272-9551

NPI assigned

Dec 12, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. William L. Nickel, DDSNPI 1649283847

Title

President

Phone

(847) 272-9516

Specialties & licenses 1

Addresses

Other names 1

• North Suburban Center for Oral & Facial Surgery Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• William Louis Nickel, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Winnetka, IL
  • NPI 1649283847
  Medicare reassignment NPD Authorized official
• Mark J Steinberg, MD DDS

  • Oral and Maxillofacial Pathology Dentistry
  • Maywood, IL
  • NPI 1477622801
  Medicare reassignment NPD
• Kyle James Hresko, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Gurnee, IL
  • NPI 1902345762
  NPD
• Benjamin Anthony Logiudice, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Deerfield, IL
  • NPI 1255341178
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1197417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197417600000",
    "number": "1063695104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1240 MEADOW RD",
            "address_2": "SUITE 300",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600628300",
            "telephone_number": "847-272-9516",
            "fax_number": "847-272-9551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 MEADOW RD",
            "address_2": "SUITE 300",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600628300",
            "telephone_number": "847-272-9516",
            "fax_number": "847-272-9551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH SUBURBAN ORAL SURGERY, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-12",
        "last_updated": "2007-12-12",
        "status": "A",
        "authorized_official_last_name": "NICKEL",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-272-9516",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Suburban Center for Oral & Facial Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• North Shore Vein Clinics LLC
• North Shore Wellness Center
• North Shore Wellness Services, LTD.
• North Star Behavioral Health, LTD
• North Suburban Center for Anxiety, LLC
• North Suburban Psychologists Inc.
• Northbrook Chiropractic and Natural Care Center SC
• Northbrook Court Dental Associates,P.C.
• Northbrook Dental Care LLC
• Northbrook Dental Care, LTD.

• Oral and Maxillofacial Surgery (Dentist) in Northbrook, IL
• Providers in Northbrook, IL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.