| Homewood Oral Surgery Pc | |
|
2158 W. 183rd Street Homewood IL 60430-3238 | |
| (708) 798-4730 | |
| (708) 798-4963 |
| Full Name | Homewood Oral Surgery Pc |
|---|---|
| Speciality | Dentist |
| Location | 2158 W. 183rd Street, Homewood, Illinois |
| Authorized Official Name and Position | George E Morris (OWNER) |
| Authorized Official Contact | 7087984730 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Homewood Oral Surgery Pc 2158 W. 183rd Street Homewood IL 60430-3238 Ph: (708) 798-4730 | Homewood Oral Surgery Pc 2158 W. 183rd Street Homewood IL 60430-3238 Ph: (708) 798-4730 |
| NPI Number | 1154598902 |
|---|---|
| Provider Enumeration Date | 05/12/2008 |
| Last Update Date | 08/11/2025 |
| Medicare PECOS PAC ID | 6002982626 |
|---|---|
| Medicare Enrollment ID | O20080905000306 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154598902 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 019019289 (Illinois) | Primary |
| 204E00000X | Oral & Maxillofacial Surgery | (* (Not Available)) | Secondary |
| Provider Name | George E Morris |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1740202969 PECOS PAC ID: 6103992722 Enrollment ID: I20080905000296 |
| Provider Name | Laila Malaki |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1194201996 PECOS PAC ID: 5294070421 Enrollment ID: I20220831000112 |
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