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General NPI Number Information
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NPI Number | 1154598902
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Entity Type | Organization
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Legal Business Name | HOMEWOOD ORAL SURGERY PC
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Dates
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Enumeration Date | 05/12/2008
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Last Update Date | 08/11/2025
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Provider Practice Location Address
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Address Line | 2158 W. 183RD STREET
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City | HOMEWOOD
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State | IL
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Zip | 60430-3238
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Country | US
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Telephone | 708-798-4730
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Fax | 708-798-4963
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Provider Business Mailing Address
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Address Line | 2158 W. 183RD STREET
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City | HOMEWOOD
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State | IL
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Zip | 60430-3238
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Country | US
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Telephone | 708-798-4730
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Fax | 708-798-4963
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Authorized Official
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Title or Position | OWNER
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Name | DR. GEORGE E MORRIS JR.
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Credential | DDS
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Telephone | 708-798-4730
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 019019289
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License Number State | IL
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