NPI
Shady Oak Dental Llc Oral And Maxillofacial Surgeons Of Northwest Il
This page is a copy of the public NPPES file.
Facts
- Status
- Active
- Type
- Organization
- Enumeration date
- 2019-07-30
- Last updated
- 2019-07-30
Specialties
Licenses
The registry row did not include a license.
Location
- Practice location
- 208 N Walnut Ave
- City
- Forreston IL
- Postal code
- 61030-9330
- Phone
- (815) 938-2575
Organization contact
- Name
- SCOTT BARES
- Title
- President
- Phone
- 8159382575
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
No exclusion found for this NPI in the OIG LEIE file dated October 9, 2026. OIG's online search is the official check.
Nearby
Other NPIs in Forreston, IL. 15 records in the public file.
Removal request
Public data from NPPES and CMS. Not a credentialing determination.
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