# NORTH SUBURBAN ORAL SURGERY, LTD

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- **Entity:** Organization
- **Status:** Active
- **Other names:** North Suburban Center for Oral & Facial Surgery
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063695104
- **Authorized official:** DR. WILLIAM L. NICKEL DDS (PRESIDENT)
- **Authorized official phone:** (847) 272-9516

## Contact information

- **Practice address:** 1240 MEADOW RD, SUITE 300, NORTHBROOK, IL 60062-8300
- **Practice address phone:** (847) 272-9516
- **Practice address fax:** (847) 272-9551
- **Mailing address:** 1240 MEADOW RD, SUITE 300, NORTHBROOK, IL 60062-8300
- **Mailing address phone:** (847) 272-9516
- **Mailing address fax:** (847) 272-9551

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | IL | Yes |

## Other

- **Enumeration date:** 12/12/2007
- **Last updated:** 12/12/2007