OrganizationActive
Hpoms
NPI 1588070148 · Oral and Maxillofacial Surgery Clinic/Center · Highland Park, IL
Provider details
- NPI number
- 1588070148
- Entity type
- Organization
- Primary specialty
- Oral and Maxillofacial Surgery Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Mark Jacob, Owner(847) 433-6636
- License
- 019.022948 (IL)
Specialties & taxonomies
Ambulatory Health Care Facilities
Ambulatory Health Care Facilities
Practice location
1893 Sheridan Rd Suite 311
Highland Park, IL 60035
Phone: (847) 433-6636
Fax: (847) 433-2090
Approximate (ZIP-level) locationGet directions
Mailing address
1893 Sheridan Rd Suite 311
Highland Park, IL 60035
Registry dates
- Enumerated
- 2014-07-03
- Last updated
- 2014-07-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.