OrganizationActive
Lakeside Oral & Facial Surgery Institute
NPI 1205288982 · Oral and Maxillofacial Surgery Clinic/Center · Evanston, IL
Provider details
- NPI number
- 1205288982
- Entity type
- Organization
- Primary specialty
- Oral and Maxillofacial Surgery Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Alan Harvey, Oral & Maxillofacial Surgeon(847) 328-8899
- License
- 021002718 (IL)
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
2500 Ridge Ave
Suite 302
Evanston, IL 60201-2455
Phone: (847) 328-8899
Fax: (847) 563-1350
Approximate (ZIP-level) locationGet directions
Mailing address
2500 Ridge Ave
Evanston, IL 60201-2455
Registry dates
- Enumerated
- 2016-07-06
- Last updated
- 2018-04-19
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.