Organization
KANKAKEE VALLEY ORAL MAXILLOFACIAL SURGERY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. INEKE CATHERINE BASILE (OFFICE MANAGER)
(815) 933-0990
Entity
Organization
Contact information
Practice address
31 BRIARCLIFF PROFESSIONAL CTR., BOURBONNAIS, IL 60914
(815) 933-0990
(815) 933-0990
Mailing address
31 BRIARCLIFF PROFESSIONAL CTR., BOURBONNAIS, IL 60914
(815) 933-0990
(815) 933-0990
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
02/11/2021
Last updated
02/11/2021
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