KANKAKEE VALLEY ORAL MAXILLOFACIAL SURGERY PC
NPI 1245822162
Dentist - Oral and Maxillofacial Surgery in Bourbonnais, IL

Q: What is Kankakee Valley Oral Maxillofacial Surgery PC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Active since February 11, 2021

31 BRIARCLIFF PROFESSIONAL CTR., BOURBONNAIS, IL 60914(815) 933-0990(815) 933-0990 Get Directions Write a Review

NPPES record last updated: February 11, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Kankakee Valley Oral Maxillofacial Surgery Pc NPPES

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

KANKAKEE VALLEY ORAL MAXILLOFACIAL SURGERY PC (NPI 1245822162) is a healthcare organization registered as an oral and maxillofacial surgery in Bourbonnais, Illinois and active in the NPI registry since February 2021. The organization lists Ineke Catherine Basile, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1245822162

Entity TypeOrganization

Primary Taxonomy1223S0112X

Legal Business NameKANKAKEE VALLEY ORAL MAXILLOFACIAL SURGERY PC

Location Address31 BRIARCLIFF PROFESSIONAL CTR.Bourbonnais, IL 60914

Mailing Address31 Briarcliff Professional Ctr.Bourbonnais, IL 60914 · (815) 933-0990 · Fax (815) 933-0990

Phone(815) 933-0990

Fax(815) 933-0990

Organization SubpartNo

Authorized OfficialIneke Catherine BasileOffice Manager · (815) 933-0990

Enumeration DateFebruary 11, 2021

NPPES CertifiedJanuary 22, 2021

✔ NPI 1245822162 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers

Taxonomy Code1223S0112X

Definition

An oral and maxillofacial surgery dentist 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.

31 BRIARCLIFF PROFESSIONAL CTR., Bourbonnais, IL 60914

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kankakee Valley Oral Maxillofacial Surgery PC's NPI number?

The NPI number for Kankakee Valley Oral Maxillofacial Surgery PC is 1245822162. It was assigned to this organization in the NPPES registry on February 11, 2021.

Where is Kankakee Valley Oral Maxillofacial Surgery PC located?

Kankakee Valley Oral Maxillofacial Surgery PC is located at 31 Briarcliff Professional Ctr., Bourbonnais, IL 60914. The listed phone number is (815) 933-0990.

What is Kankakee Valley Oral Maxillofacial Surgery PC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

When was this NPI record last updated?

The NPPES record for Kankakee Valley Oral Maxillofacial Surgery PC was last updated on February 11, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.