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ROBERT C. BOSACK DDS & ASSOCIATES LTD NPI 1093232951


NPI Information

NPI: 1093232951
Provider Name: ROBERT C. BOSACK, DDS & ASSOCIATES, LTD
Classification: Dentist - 1223S0112X
Entity Type: Organization

Specialization: Oral and Maxillofacial Surgery

Address:
16011 108TH AVE STE A
ORLAND PARK, IL
ZIP 60467
Phone: (708) 460-9100
Get Directions

ROBERT C. BOSACK, DDS & ASSOCIATES, LTD is an oral and maxillofacial surgery dentist in Orland Park, IL. The provider is 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. ROBERT C. BOSACK, DDS & ASSOCIATES, LTD NPI is 1093232951. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

16011 108TH AVE STE A
ORLAND PARK, IL
ZIP 60467-787
Phone: (708) 460-9100
Fax: (708) 460-7919

The provider's authorized official is Robert C. Bosack .
The authorized official title is Owner/oral Surgeon and has the following contact phone number (708) 460-9100.

The enumeration date for this NPI number is 8/23/2017 and was last updated on 7/21/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223S0112XDentistOral and Maxillofacial Surgery021.001152ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11518250125MEDICAIDILLINOIS
21376550558MEDICAIDILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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