Individual
DR. WILLIAM GUSTAV FLICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
6305 W 95TH ST, SUITE 301, OAK LAWN, IL 60453-2255
(708) 425-4300
(708) 425-4310
Mailing address
6305 W 95TH ST, SUITE 301, OAK LAWN, IL 60453-2255
(708) 425-4300
(708) 425-4310
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
019.014839
IL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
137000009
IL
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
021001050
IL
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
137000009
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0040121107
BLUE CROSS BLUE SHIELD
IL
01
—
0091640652
BLUE CROSS BLUE SHIELD
IL
01
—
0091640653
BLUE CROSS BLUE SHIELD
IL
Enumeration date
09/06/2006
Last updated
10/25/2023
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