ORAL & MAXILLOFACIAL SURGEONS OF LAKE COUNTY, P.C. (NPI# 1023132859) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023132859 |
| Entity Type | Organization |
| Organization Name | ORAL & MAXILLOFACIAL SURGEONS OF LAKE COUNTY, P.C. |
| Practice Address |
202 S Greenleaf St Suite A Gurnee IL 60031-3399 |
| Practice Telephone | 8476232830 |
| Practice Fax Number | 8476231534 |
| Mailing Telephone | 8476232830 |
| Mailing Fax Number | 8476231534 |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2008-04-09 |
| Authorized Official Name | DR. FABIAN DAVID LATOCHA (OWNER) |
| Authorized Official Telephone | 8476232830 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0106X |
Dentist Specialization: Oral and Maxillofacial Pathology |
IL | Dental Providers |
| Street Address |
202 S GREENLEAF ST SUITE A |
| City | GURNEE |
| State | IL |
| Zip Code | 60031-3399 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033167242 | Fabian David Latocha | Dentist | 202 S Greenleaf St, Suite A, Gurnee, IL 60031-3399 | 2006-05-04 |
| 1700265592 | Samantha Wiley | Genetic Counselor, MS | 202 S Greenleaf St, Suite E, Gurnee, IL 60031-3399 | 2015-05-26 |
| 1417384306 | Waukegan Clinic Corp | Durable Medical Equipment & Medical Supplies | 202 S Greenleaf St, Suite E, Gurnee, IL 60031-3399 | 2013-10-09 |
| 1093142135 | Oncology Hematology Associates of Northern Illinois, Ltd | Internal Medicine | 202 S Greenleaf St, Suite E, Gurnee, IL 60031-3399 | 2013-10-03 |
| 1790056018 | Illinois Skilled Care, LLC | Home Health | 202 S Greenleaf St, Suite C, Gurnee, IL 60031-3399 | 2012-01-18 |
| 1790813202 | Oncology Hematology Associates of Northern Illinois, Ltd. | Specialist | 202 S Greenleaf St, Suite E, Gurnee, IL 60031 | 2007-02-28 |
| 1003973827 | Urology Specialists of Lake County, S.c. | Specialist | 202 S Greenleaf St, Suite D, Gurnee, IL 60031-3399 | 2007-01-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881174720 | Rockelle Waggoner | Behavioral Analyst | 489 Tanglewood Dr, Gurnee, IL 60031 | 2018-08-20 |
| 1316434376 | Lake County Internal Medicine Assoc LLC | Non-Pharmacy Dispensing Site | 15 Tower Ct., Ste 190, Gurnee, IL 60031 | 2018-04-16 |
| 1588163364 | Advanced Endodontics, PC | Dentist | 103 S. Greenleaf Street, Suite K, Gurnee, IL 60031 | 2018-02-07 |
| 1578081550 | Northshore Medical Consultants, Ltd | Family Medicine | 1425 Hunt Club Rd. #302, Gurnee, IL 60031 | 2017-08-30 |
| 1336678739 | Sarah Beth Fugelseth | Nurse Practitioner | 1445 N Hunt Club Rd Ste 304, Gurnee, IL 60031 | 2017-06-08 |
| 1174079867 | Lifecarepros, LLC | In Home Supportive Care | 223 North Route 21, Gurnee, IL 60031 | 2016-09-01 |
| 1740733195 | Ryan Lee Winslow | Chiropractor | 6021 Washington St, Unit B, Gurnee, IL 60031 | 2016-08-02 |
| 1891129599 | Smart Scan Mri, LLC | Clinic/Center | 350 S. Greenleaf, Suite 401, Gurnee, IL 60031 | 2013-08-29 |
| 1568720076 | Yudelca Romano | Genetic Counselor, MS | 1125 Tri State Parkway, Gurnee, IL 60031 | 2012-05-03 |
| 1558637348 | Laura E Novak | Social Worker | 4212 Old Grand Avenue, Gurnne, IL 60031 | 2012-03-27 |
| Find all providers in zip 60031 | ||||
| Taxonomy Code | 1223P0106X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Pathology |
| The specialty of dentistry and discipline of pathology that deals with the nature, identification, and management of diseases affecting the oral and maxillofacial regions. It is a science that investigates the causes, processes, and effects of these diseases. The practice of oral and maxillofacial pathology includes research and diagnosis of diseases using clinical, radiographic, microscopic, biochemical, or other examinations. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558582148 | Joel Schwartz | Dentist | 801 S Paulina, Mc 621, Chicago, IL 60612 | 2007-05-01 |
| 1982822912 | Oral and Maxillofacial Surgery Affiliates Ltd. | Dentist | 111 S Washington St., Ste 101, Park Ridge, IL 60068-4203 | 2007-04-23 |
| 1700920113 | Ordie H. King Jr. | Dentist | 6111 Vollmer Ln, Godfrey, IL 62035-1062 | 2007-02-18 |
| 1568514248 | Mark W Lingen | Dentist | 150 Harvester Dr Ste 300, Burr Ridge, IL 60527-5965 | 2007-01-16 |
| 1861402893 | Dennis Gerald Boyer | Dentist | 183 S Bloomingdale Rd Ste 205, Bloomingdale, IL 60108-1400 | 2006-08-09 |
| 1871516088 | Sara C Gordon | Dentist | 801 S Paulina Street, Dept of Oral Medicine Uic College of Dentistry Mc 838, Chicago, IL 60612-7213 | 2006-07-26 |
| 1114967205 | Jerome E. Schoen | Dentist | 303 N Northwest Hwy, Barrington, IL 60010-3396 | 2006-06-07 |
| 1558312371 | James A Morrone | Dentist | 120 Oakbrook Ctr, Suite 700, Oak Brook, IL 60523-1806 | 2006-05-15 |
| 1205808854 | Reza Mostofi | Dentist | 3407 W Bryn Mawr Ave, Chicago, IL 60659-3450 | 2006-02-06 |
| 1710413091 | Kathleen Higgins | Dentist | 5841 S Maryland Ave # Mc3083, Chicago, IL 60637-1443 | 2017-05-05 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.