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

Lakeside Oral & Facial Surgery Institute

Organization Oral and Maxillofacial Surgery Clinic/Center · NPI 1205288982

Lakeside Oral & Facial Surgery Institute is an Oral and Maxillofacial Surgery Clinic/Center in Evanston, Illinois. Licensed in Illinois. Registered with an NPI since 2016.

Licensed in
IL
In the registry since
2016

Practice location Address checks out

2500 Ridge Ave Ste 302
Evanston, IL 60201-2455
Phone: (847) 328-8899
Fax: (847) 563-1350
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral and Maxillofacial Surgery Clinic/Center (primary) Taxonomy 261QS0112X · Licence 021002718 (IL)

Record details

NPI number1205288982
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Alan Harvey — Oral & Maxillofacial Surgeon · (847) 328-8899
NPI enumeratedJuly 6, 2016
Last updated in NPPESApril 19, 2018
Mailing address2500 Ridge Ave, Suite 302, Evanston, IL 60201-2455

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