| Hpoms | |
|
1893 Sheridan Rd Suite 311 Highland Park IL 60035 | |
| (847) 433-6636 | |
| (847) 433-2090 |
| Full Name | Hpoms |
|---|---|
| Speciality | Clinic/center - Oral And Maxillofacial Surgery |
| Location | 1893 Sheridan Rd Suite 311, Highland Park, Illinois |
| Authorized Official Name and Position | Mark B Jacob (OWNER) |
| Authorized Official Contact | 8474336636 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hpoms 1893 Sheridan Rd Suite 311 Highland Park IL 60035 Ph: (847) 433-6636 | Hpoms 1893 Sheridan Rd Suite 311 Highland Park IL 60035 Ph: (847) 433-6636 |
| NPI Number | 1588070148 |
|---|---|
| Provider Enumeration Date | 07/03/2014 |
| Last Update Date | 07/03/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588070148 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 019.022948 (Illinois) | Secondary |
| 261QS0112X | Clinic/center - Oral And Maxillofacial Surgery | 021.002059 (Illinois) | Primary |
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