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CRYSTAL LAKE ORAL MAXILLOFACIAL SURGERY LTD
NPI 1730197468
Dentist - Oral and Maxillofacial Surgery in Crystal Lake, IL

Active since August 05, 2006
690 N IL ROUTE 31, CRYSTAL LAKE, IL 60012(815) 459-5600(815) 459-5615 Get Directions Write a Review

NPPES record last updated: June 3, 2010. Verified against the NPPES registry weekly; last sync: October 04, 2026.

About Crystal Lake Oral Maxillofacial Surgery Ltd NPPES

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

CRYSTAL LAKE ORAL MAXILLOFACIAL SURGERY LTD (NPI 1730197468) is a healthcare organization registered as an oral and maxillofacial surgery in Crystal Lake, Illinois and active in the NPI registry since August 2006. The organization lists Kurt E Bruksch, Vice-president, as its authorized official.

NPPES Registry Identity

NPI1730197468
Entity TypeOrganization
Primary Taxonomy1223S0112X
Legal Business NameCRYSTAL LAKE ORAL MAXILLOFACIAL SURGERY LTD
Location Address690 N IL ROUTE 31Crystal Lake, IL 60012-3790
Mailing Address690 N Il Route 31Crystal Lake, IL 60012-3790 · (815) 459-5600 · Fax (815) 459-5615
Phone(815) 459-5600
Fax(815) 459-5615
Organization SubpartNo
Authorized OfficialKurt E BrukschVice-president · (815) 459-5600
Enumeration DateAugust 5, 2006
Last NPPES UpdateJune 3, 2010
✔ NPI 1730197468 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
License✔ Licensed in IL · 019018137
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.
690 N IL ROUTE 31, Crystal Lake, IL 60012
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Other Identifiers 13

Medicare ID-Type Unspecified761910IL · Dr. Kurt Bruksch
Other1700865441Npi # Dr. John Richard
Medicaid019013457IL
Medicare UPINT37819IL
Medicare UPINU81648IL
Medicare ID-Type Unspecified206350IL · Dr. Thomas Skiba
Medicare ID-Type Unspecified594150IL · Dr. Adam Ozment
Medicaid019018137IL
Medicaid019025282ID
Medicare UPINT38692IL
Medicaid019016621IL
Medicare UPINT35304IL
Medicare ID-Type Unspecified683930IL · Dr. Robert Conlon

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

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. CANDACE MARIE OPON D.D.S.
Dentist (General Practice)
690 N IL ROUTE 31
CRYSTAL LAKE, IL 60012
McHenry County (815) 477-2177
DR. FRED M FITZPATRICK D.D.S.
Dentist (Pediatric Dentistry)
690 N IL ROUTE 31
CRYSTAL LAKE, IL 60012
McHenry County (815) 459-2727
DR. JACK AUSTIN HARRIS DMD
Dentist (Oral and Maxillofacial Surgery)
690 N IL ROUTE 31
CRYSTAL LAKE, IL 60012
McHenry County (815) 459-5600
DR. THOMAS ARTHUR KOPP DDS.
Dentist
690 N IL ROUTE 31
CRYSTAL LAKE, IL 60012
McHenry County (815) 477-4055
PEDIATRIC DENTAL ASSOCIATES, PC
Dentist (Pediatric Dentistry)
690 N IL ROUTE 31, SUITE D
CRYSTAL LAKE, IL 60012
McHenry County (815) 459-2727
FREDERICK M. FITZPATRICK, D.D.S., P.C.
Dentist (Pediatric Dentistry)
690 N IL ROUTE 31
CRYSTAL LAKE, IL 60012
McHenry County (815) 459-2727
DR. DENNIS JAMES MCDOWELL D.D.S.
Dentist
690 N IL ROUTE 31, SUITE E
CRYSTAL LAKE, IL 60012
McHenry County (815) 455-6120
FRAZIER & KOPP DDS PC
Dentist
690 N IL ROUTE 31
CRYSTAL LAKE, IL 60012
McHenry County (815) 477-4055

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 Crystal Lake Oral Maxillofacial Surgery Ltd's NPI number?

The NPI number for Crystal Lake Oral Maxillofacial Surgery Ltd is 1730197468. It was assigned to this organization in the NPPES registry on August 5, 2006.

Where is Crystal Lake Oral Maxillofacial Surgery Ltd located?

Crystal Lake Oral Maxillofacial Surgery Ltd is located at 690 N Il Route 31, Crystal Lake, IL 60012. The listed phone number is (815) 459-5600.

What is Crystal Lake Oral Maxillofacial Surgery Ltd'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 Crystal Lake Oral Maxillofacial Surgery Ltd was last updated on June 3, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.