| Robert C. Bosack, Dds & Associates, Ltd | |
|
16011 108th Ave Ste A Orland Park IL 60467-8787 | |
| (708) 460-9100 | |
| (708) 460-7919 |
| Full Name | Robert C. Bosack, Dds & Associates, Ltd |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 16011 108th Ave Ste A, Orland Park, Illinois |
| Authorized Official Name and Position | Robert C. Bosack (OWNER/ORAL SURGEON) |
| Authorized Official Contact | 7084609100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Robert C. Bosack, Dds & Associates, Ltd 16011 108th Ave Ste A Orland Park IL 60467-8787 Ph: (708) 460-9100 | Robert C. Bosack, Dds & Associates, Ltd 16011 108th Ave Ste A Orland Park IL 60467-8787 Ph: (708) 460-9100 |
| NPI Number | 1093232951 |
|---|---|
| Provider Enumeration Date | 08/23/2017 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093232951 | NPI | - | NPPES |
| 1518250125 | Medicaid | IL | |
| 1376550558 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 021.001152 (Illinois) | Primary |
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