| Advanced Oral & Maxillofacial Surgery Ltd. | |
|
533 W North Ave. Suite 200 Elmhurst IL 60126-2100 | |
| (630) 941-3400 | |
| (630) 941-3421 |
| Full Name | Advanced Oral & Maxillofacial Surgery Ltd. |
|---|---|
| Speciality | Dentist |
| Location | 533 W North Ave., Elmhurst, Illinois |
| Authorized Official Name and Position | Mark Wolf (PRESIDENT) |
| Authorized Official Contact | 6309413400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Oral & Maxillofacial Surgery Ltd. 533 W North Ave. Suite 200 Elmhurst IL 60126-2100 Ph: (630) 941-3400 | Advanced Oral & Maxillofacial Surgery Ltd. 533 W North Ave. Suite 200 Elmhurst IL 60126-2100 Ph: (630) 941-3400 |
| NPI Number | 1700956273 |
|---|---|
| Provider Enumeration Date | 11/09/2006 |
| Last Update Date | 06/16/2010 |
| Medicare PECOS PAC ID | 7810068657 |
|---|---|
| Medicare Enrollment ID | O20080620000587 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700956273 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Secondary |
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 060.003899 (Illinois) | Primary |
| Provider Name | Philip L Lin |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1407086416 PECOS PAC ID: 7315241551 Enrollment ID: I20171009001667 |
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