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

Kankakee Valley Oral Maxillofacial Surgery PC

Organization Oral and Maxillofacial Surgery (Dentist) · NPI 1245822162

Kankakee Valley Oral Maxillofacial Surgery PC is an Oral and Maxillofacial Surgery (Dentist) in Bourbonnais, Illinois. Registered with an NPI since 2021.

In the registry since
2021
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

31 Briarcliff Professional Ctr
Bourbonnais, IL 60914
Phone: (815) 933-0990
Fax: (815) 933-0990
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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

Record details

NPI number1245822162
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Ineke Basile — Office Manager · (815) 933-0990
NPI enumeratedFebruary 11, 2021
Last updated in NPPESFebruary 11, 2021
Certification dateJanuary 22, 2021
Mailing address31 Briarcliff Professional Ctr., Bourbonnais, IL 60914

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