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

Lakeside Oral & Implant Surgery Institute, PC

Organization Oral and Maxillofacial Surgery Clinic/Center · NPI 1679070189

Lakeside Oral & Implant Surgery Institute, PC is an Oral and Maxillofacial Surgery Clinic/Center in Chicago, Illinois. Licensed in Illinois. Registered with an NPI since 2018.

Licensed in
IL
In the registry since
2018
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

5758 S Maryland Ave # 4H
Chicago, IL 60637-1426
Phone: (773) 702-1865
Fax: (773) 834-3888
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 number1679070189
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Alan Harvey — Oral & Maxillofacial Surgeon · (773) 702-1865
NPI enumeratedApril 11, 2018
Last updated in NPPESApril 11, 2018
Mailing address5841 S Maryland Ave # Mc9020, Chicago, IL 60637-1443

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