HIGHLAND PARK OMS (NPI# 1912283730) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912283730 |
| Entity Type | Organization |
| Organization Name | HIGHLAND PARK OMS |
| Practice Address |
1893 Sheridan Rd Suite 311 Highland Park IL 60035-2628 |
| Mailing Address |
1893 Sheridan Rd Suite 311 Highland Park IL 60035 |
| Practice Telephone | 8474336636 |
| Practice Fax Number | 8474332090 |
| Mailing Telephone | 8474336636 |
| Mailing Fax Number | 8474332090 |
| Enumeration Date | 2011-10-25 |
| Last Update Date | 2011-10-25 |
| Authorized Official Name | DR. MARK B JACOB (OWNER) |
| Authorized Official Telephone | 8474336636 |
| Authorized Official Credential | DDS, MS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
019022948 | IL | Dental Providers |
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
021002059 | IL | Dental Providers |
| Street Address |
1893 SHERIDAN RD SUITE 311 |
| City | HIGHLAND PARK |
| State | IL |
| Zip Code | 60035-2628 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154320042 | Lauren K Jacker | Psychiatry & Neurology | 1893 Sheridan Rd, #303, Highland Park, IL 60035-2628 | 2005-07-21 |
| 1841786464 | Cindy Robinson | Counselor | 1893 Sheridan Rd, Highland Park, IL 60035-2628 | 2018-07-06 |
| 1487044335 | Lauren Jacker Md LLC | Psychiatry & Neurology | 1893 Sheridan Rd, Suite 303, Highland Park, IL 60035-2628 | 2015-01-30 |
| 1417198169 | Randal A. Knudson Dds PC | Dentist | 1893 Sheridan Rd, Suite 315, Highland Park, IL 60035-2628 | 2009-03-10 |
| 1699949958 | David Smyth | Dentist | 1893 Sheridan Rd, Suite 301, Highland Park, IL 60035-2628 | 2008-04-17 |
| 1548481872 | Jan Brenner | Speech-Language Pathologist | 1893 Sheridan Rd, Suite Number 303, Highland Park, IL 60035-2628 | 2007-05-02 |
| 1851518468 | Wendy C Abrams | Speech-Language Pathologist | 1893 Sheridan Rd, Suite 303, Highland Park, IL 60035-2628 | 2007-04-18 |
| 1245352442 | Steven Craig Sommerfeld | Dentist | 1893 Sheridan Rd, Suite 309, Highland Park, IL 60035-2628 | 2007-04-06 |
| 1295859874 | Stephen Terence Herczeg | Psychologist | 1893 Sheridan Rd, 302, Highland Park, IL 60035-2628 | 2007-03-19 |
| 1205902194 | Keith Mellovitz | Dentist | 1893 Sheridan Rd, Suite 318, Highland Park, IL 60035 | 2006-11-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770140006 | Julian Jay Freeman | Internal Medicine | 1954 1st St., Suite 263, Highland Park, IL 60035 | 2019-05-22 |
| 1851838858 | Melissa Block | Lactation Consultant, Non-RN | 303 Sheridan Road, Highland Park, IL 60035 | 2017-01-27 |
| 1750838280 | Megan Hyatt | Physical Therapist | Central Parkway, Store #210, Highland Park, IL 60035 | 2016-09-01 |
| 1962865907 | Timothy C Dennis | Counselor | 1724 1st St., Nicasa, Highland Park, IL 60035 | 2016-03-29 |
| 1821458027 | Sarah Marie Pinger | Counselor | 1724 1st Street, Highland Park, IL 60035 | 2016-03-01 |
| 1508262775 | Jennifer Francis Gilbert | Social Worker | 1067 Centerfield Court, Highland Park, IL 60035 | 2014-11-14 |
| 1588070148 | Hpoms | Clinic/Center | 1893 Sheridan Rd Suite 311, Highland Park, IL 60035 | 2014-07-03 |
| 1477974152 | Mtca Psychological Services of Illinois P.C. | Psychologist | 1651 Richfield Avenue, Highland Park, IL 60035 | 2013-12-23 |
| 1760819510 | Linda Beth Greco | Social Worker | 274 Linden Park Place, Highland Park, IL 60035 | 2013-10-10 |
| 1770821373 | Eve Cooper Agin | Counselor | 1866 Sheridan Road, Suite 203, Highland Park, IL 60035 | 2013-01-17 |
| Find all providers in zip 60035 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861647588 | Nathan Braverman Dmd Md PC | Dentist | 1770 First St., 350, Highland Park, IL 60035-3200 | 2008-11-21 |
| 1205945425 | Nathan Alan Braverman | Dentist | 1770 First Street, Suite 350, Highland Park, IL 60035-5601 | 2006-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255986576 | Othman Rezki | Dentist | 1900 W Polk St # 611, Chicago, IL 60612-3723 | 2019-08-04 |
| 1215410584 | David Peterson | Dentist | 1619 Brandywine Ln, Dixon, IL 61021-8757 | 2018-09-12 |
| 1952887374 | Winnebago Braces, LLC. | Dentist | 555 N Court St Ste 110, Rockford, IL 61103-6898 | 2018-07-18 |
| 1093232951 | Robert C. Bosack, Dds & Associates, Ltd | Dentist | 16011 108th Ave Ste A, Orland Park, IL 60467-8787 | 2017-08-23 |
| 1790146132 | Family Millennium Dentistry, Inc. | Dentist | 1342 W Randolph St, Chicago, IL 60607-1522 | 2016-03-13 |
| 1770962375 | Eunsu Jung | Dentist | 1902 N Prospect Ave Ste 1, Champaign, IL 61822-1411 | 2015-05-28 |
| 1811374945 | Alexandria Hawkins | Dentist | 6050 Brynwood Dr Ste 102, Rockford, IL 61114-6579 | 2015-04-27 |
| 1043607872 | Alissa Nicole Pullos | Dentist | 105 E 1st St Ste 103, Hinsdale, IL 60521 | 2015-04-20 |
| 1538592654 | Matthew Seena Hamedani | Dentist | 3116 Oak Park Ave, Berwyn, IL 60402 | 2013-08-13 |
| 1578907689 | M Timothy Murphy | Dentist | 500 Davis St Ste 509, Evanston, IL 60201-4621 | 2013-04-18 |
| Find all providers with the same taxonomy | ||||
| City | HIGHLAND PARK |
| Zip Code | 60035 |
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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.