Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Crystal Lake Oral Maxillofacial Surgery Ltd

Organization Oral and Maxillofacial Surgery (Dentist) · NPI 1730197468

Crystal Lake Oral Maxillofacial Surgery Ltd is an Oral and Maxillofacial Surgery (Dentist) in Crystal Lake, Illinois. Licensed in Illinois. Registered with an NPI since 2006.

Licensed in
IL
In the registry since
2006
What do these letters mean?
Ltd — Limited
A form of business registration, not a clinical qualification.

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Practice location Address checks out

690 N Il Route 31
Crystal Lake, IL 60012-3790
Phone: (815) 459-5600
Fax: (815) 459-5615
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral and Maxillofacial Surgery (Dentist) (primary) Taxonomy 1223S0112X · Licence 019018137 (IL)

Record details

NPI number1730197468
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kurt Bruksch — Vice-President · (815) 459-5600
NPI enumeratedAugust 5, 2006
Last updated in NPPESJune 3, 2010
Mailing address690 N Il Route 31, Crystal Lake, IL 60012-3790

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