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General NPI Number Information
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NPI Number | 1427478429
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Entity Type | Organization
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Legal Business Name | ANTIOCH ORAL AND MAXILLOFACIAL SURGERY ASSOCIATES P.C.
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Dates
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Enumeration Date | 04/17/2014
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Last Update Date | 10/29/2024
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Provider Practice Location Address
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Address Line | 21880 N. HARBOR RD.
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City | BARRINGTON
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State | IL
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Zip | 60010
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Country | US
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Telephone | 708-650-7777
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Fax | 847-395-7956
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Provider Business Mailing Address
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Address Line | 21880 N. HARBOR RD.
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City | BARRINGTON
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State | IL
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Zip | 60010
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Country | US
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Telephone | 708-650-7777
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Fax | 847-395-7956
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. CHRIS NICHOLAS CHOUKAS
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Credential | DDS
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Telephone | 708-650-7777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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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 | 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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