Mark F. Erickson, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Practice address

383 S Schmale Rd
Carol Stream, IL 60188-2756

Phone

(630) 909-0500

Fax

(630) 909-0800

NPI assigned

Oct 6, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 20, 2011 through Jan 20, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Erickson Oral & Maxillofacial Surgery, LLC

  dba Prairie Path Oral Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Carol Stream, IL
  • NPI 1215794060
  NPD Authorized official

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

{
    "created_epoch": "1128556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1336137157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8685 TIMBER RIDGE DR",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605275694",
            "telephone_number": "630-850-7780",
            "fax_number": "630-850-7781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "383 S SCHMALE RD",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601882756",
            "telephone_number": "630-909-0500",
            "fax_number": "630-909-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERICKSON",
        "first_name": "MARK",
        "middle_name": "F.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-06",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rosemary Fady Elmalh
• Kevin Enberg, D.D.S.
• Enhance Medical PLLC
• Eric N. Potocki
• Erickson Oral & Maxillofacial Surgery, LLC (Prairie Path Oral Surgery)
• Richard E. Erickson, M.D.
• Nicole Ethridge, O.D.
• Elijah Ewasiuk
• Judith A Fawell, LPC, CADC
• Jennifer M. Felske, D.P.M.

• Oral and Maxillofacial Surgery (Dentist) in Carol Stream, IL
• Providers in Carol Stream, 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 Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.