OrganizationActive
Crystal Lake Oral Maxillofacial Surgery Ltd
NPI 1730197468 · Oral and Maxillofacial Surgery (Dentist) · Crystal Lake, IL
Provider details
- NPI number
- 1730197468
- Entity type
- Organization
- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)Dental Providers
- Organization subpart
- No
- Authorized official
- Kurt Bruksch, Vice-President(815) 459-5600
- License
- 019018137 (IL)
Specialties & taxonomies
Dental Providers
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 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
690 N Il Route 31
Crystal Lake, IL 60012-3790
Phone: (815) 459-5600
Fax: (815) 459-5615
Street-level locationGet directions
Mailing address
690 N Il Route 31
Crystal Lake, IL 60012-3790
Registry dates
- Enumerated
- 2006-08-05
- Last updated
- 2010-06-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.