Maxillofacial and Facial Aesthetic Surgery

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

Legal business name

MAXILLOFACIAL AND FACIAL AESTHETIC SURGERY

Practice address

426 S 3Rd St
Geneva, IL 60134-2708

Phone

(630) 232-9090

Fax

(630) 232-9094

NPI assigned

Apr 10, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Kevin Ray Haddle, MD, DDS

Title

Physician Owner

Phone

(630) 232-9090

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1207785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207785600000",
    "number": "1992978852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "426 S 3RD ST",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601342708",
            "telephone_number": "630-232-9090",
            "fax_number": "630-232-9094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "426 S 3RD ST",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601342708",
            "telephone_number": "630-232-9090",
            "fax_number": "630-232-9094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAXILLOFACIAL AND FACIAL AESTHETIC SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-10",
        "last_updated": "2008-04-10",
        "status": "A",
        "authorized_official_last_name": "HADDLE",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "630-232-9090",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lannah M Mason
• Gail E Mastio, LCSW
• Iliana Mata
• Mathew McFadden, PSYD, PLLC
• Matthew S Hendrickson, OD & Associates PC (Clarity Eye Care)
• Amy M May, R.N., B.S.N.
• Gabriella M May
• Shannon Patricia Mayer, LCSW
• Jared Michael McCaffrey
• Ryan James McCall, DDS

• Oral & Maxillofacial Surgery (D.M.D.) in Geneva, IL
• Providers in Geneva, IL by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 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.