OrganizationActive
Facial Cosmetic & Reconstructive Surgery, Sc
NPI 1417123076 · Oral and Maxillofacial Surgery Clinic/Center · Dunlap, IL
Provider details
- NPI number
- 1417123076
- Entity type
- Organization
- Primary specialty
- Oral and Maxillofacial Surgery Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Wendy Morrison, Office Manager(309) 243-8980
- License
- 019025195 (IL)
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Detailed profile(87/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
11825 N Knoxville Ave
Dunlap, IL 61525-8842
Phone: (309) 243-8980
Fax: (309) 243-8983
Street-level locationGet directions
Mailing address
11825 N Knoxville Ave
Dunlap, IL 61525-8842
Registry dates
- Enumerated
- 2008-05-05
- Last updated
- 2008-05-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.