OrganizationActive
Central Illinois Oral and Maxillofacial Surgery, PC
NPI 1669540399 · Oral and Maxillofacial Surgery (Dentist) · Champaign, IL
Provider details
- NPI number
- 1669540399
- Entity type
- Organization
- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)Dental Providers
- Parent organization
- Central Illinois Oral and Maxillofacial Surgery, PC
- Organization subpart
- Yes
- Authorized official
- Amy Kroeger, Insurance Coordinator(217) 540-5100
Specialties & taxonomies
Dental Providers
Practice location
14 E Anthony Dr
Suite C
Champaign, IL 61820-2748
Phone: (217) 355-2809
Fax: (217) 355-5921
Approximate (ZIP-level) locationGet directions
Mailing address
14 E Anthony Dr
Champaign, IL 61820-2748
Other names (DBA / former)
- Doing business as
- Champaign Oral Surgery Center
- Doing business as
- Champaign Oral Surgery Center
Registry dates
- Enumerated
- 2006-12-01
- Last updated
- 2023-08-23
- Certified
- 2023-08-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.