Organization Active NPI

M Lauck SC

  • Oral and Maxillofacial Surgery (Dentist)
  • Elmhurst, IL
National Provider Identifier
1295909240
Registry record updated Apr 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
019013525 Issued in IL
Legal business name
M LAUCK SC
Practice address
360 W Butterfield Rd
Suite 220
Elmhurst, IL 60126-5068
Phone
(630) 833-0395
NPI assigned
Apr 19, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2008

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

Authorized official

Name
Dr. Michael James Lauck, D.D.S.
Title
President
Phone
(630) 833-0395

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X 019013525 IL Primary

Addresses

Primary practice location

360 W Butterfield Rd
Suite 220
Elmhurst, IL 60126-5068

Mailing address

360 W Butterfield Rd
Suite 220
Elmhurst, IL 60126-5068
Phone (630) 833-0395

National Provider Directory

National Provider Directory

Locations

538 W North Ave
Elmhurst, IL 60126
Phone (630) 833-0122

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1208563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208995200000",
    "number": "1295909240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 W BUTTERFIELD RD",
            "address_2": "SUITE 220",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601265068",
            "telephone_number": "630-833-0395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 W BUTTERFIELD RD",
            "address_2": "SUITE 220",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601265068",
            "telephone_number": "630-833-0395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M LAUCK SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-19",
        "last_updated": "2008-04-24",
        "status": "A",
        "authorized_official_last_name": "LAUCK",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-833-0395",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IL",
            "license": "019013525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.