OrganizationActive
Chicago Oral & Maxillofacial Surgery
NPI 1366599748 · Oral and Maxillofacial Surgery (Dentist) · Chicago, IL
Provider details
- NPI number
- 1366599748
- Entity type
- Organization
- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)Dental Providers
- Organization subpart
- No
- Authorized official
- Neil Hagen, Owner(312) 926-2929
- License
- 21-001074 (IL)
Specialties & taxonomies
Dental Providers
Practice location
676 N St. Clair Street
Suite 2280
Chicago, IL 60611-3197
Phone: (312) 926-2929
Fax: (312) 926-3595
Approximate (ZIP-level) locationGet directions
Mailing address
676 N St. Clair Street
Chicago, IL 60611-3197
Registry dates
- Enumerated
- 2007-01-05
- Last updated
- 2009-05-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.