| Kankakee Valley Oral Maxillofacial Surgery Pc | |
|
31 Briarcliff Professional Ctr. Bourbonnais IL 60914 | |
| (815) 933-0990 | |
| (815) 933-0990 |
| Full Name | Kankakee Valley Oral Maxillofacial Surgery Pc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 31 Briarcliff Professional Ctr., Bourbonnais, Illinois |
| Authorized Official Name and Position | Ineke Catherine Basile (OFFICE MANAGER) |
| Authorized Official Contact | 8159330990 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kankakee Valley Oral Maxillofacial Surgery Pc 31 Briarcliff Professional Ctr. Bourbonnais IL 60914 Ph: (815) 933-0990 | Kankakee Valley Oral Maxillofacial Surgery Pc 31 Briarcliff Professional Ctr. Bourbonnais IL 60914 Ph: (815) 933-0990 |
| NPI Number | 1245822162 |
|---|---|
| Provider Enumeration Date | 02/11/2021 |
| Last Update Date | 02/11/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245822162 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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