LAKESIDE ORAL & FACIAL SURGERY INSTITUTE
NPI 1205288982
Clinic/Center - Oral and Maxillofacial Surgery in Evanston, IL

Q: What is the provider's specialty?

The provider's specialty is Clinic/Center with taxonomy code 261QS0112X and a focus in Oral and Maxillofacial Surgery.

Active since July 06, 2016

2500 RIDGE AVE, SUITE 302, EVANSTON, IL 60201(847) 328-8899(847) 563-1350 Get Directions Write a Review

NPPES record last updated: April 19, 2018. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Lakeside Oral & Facial Surgery Institute NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LAKESIDE ORAL & FACIAL SURGERY INSTITUTE (NPI 1205288982) is a healthcare organization registered as an oral and maxillofacial surgery in Evanston, Illinois and active in the NPI registry since July 2016. The organization lists Alan Harvey, Oral & Maxillofacial Surgeon, as its authorized official.

NPPES Registry Identity

NPI1205288982

Entity TypeOrganization

Primary Taxonomy261QS0112X

Legal Business NameLAKESIDE ORAL & FACIAL SURGERY INSTITUTE

Location Address2500 RIDGE AVE, SUITE 302Evanston, IL 60201-2455

Mailing Address2500 Ridge Ave, Suite 302Evanston, IL 60201-2455 · (847) 328-8899 · Fax (847) 563-1350

Phone(847) 328-8899

Fax(847) 563-1350

Organization SubpartNo

Authorized OfficialAlan HarveyOral & Maxillofacial Surgeon · (847) 328-8899

Enumeration DateJuly 6, 2016

Last NPPES UpdateApril 19, 2018

✔ NPI 1205288982 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Oral and Maxillofacial SurgeryAmbulatory Health Care Facilities

Taxonomy Code261QS0112X

License✔ Licensed in IL · 021002718

Definition

An oral and maxillofacial surgery clinic or center specialized in 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.

2500 RIDGE AVE, Evanston, IL 60201

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