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Crystal Lake Oral Maxillofacial Surgery Ltd

Oral and Maxillofacial Surgery (Dentist) in Crystal Lake, IL · enumerated 2006 · authorized official Kurt Bruksch, Vice-President.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1730197468

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Registry record

Entity type Organization (Type 2)
Legal business name Crystal Lake Oral Maxillofacial Surgery Ltd
Practice address 690 N Il Route 31, Crystal Lake, IL, 60012
Fax (815) 459-5615
Enumeration date Aug 5, 2006
Last updated in NPPES Jun 3, 2010

Taxonomy & classification

1223S0112X Oral and Maxillofacial Surgery (Dentist) Dental Providers · License 019018137 (IL) Primary

Authorized official

Name Kurt Bruksch
Title Vice-President

Other identifiers

Identifier Type State Issuer
019025282 Medicaid ID -
019016621 Medicaid IL -
019018137 Medicaid IL -
019013457 Medicaid IL -
1700865441 Other - NPI # DR. JOHN RICHARD

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is the NPI number for Crystal Lake Oral Maxillofacial Surgery Ltd?
The NPI for Crystal Lake Oral Maxillofacial Surgery Ltd is 1730197468, a Type 2 (organization) record in the CMS NPPES registry.
Who is the authorized official for Crystal Lake Oral Maxillofacial Surgery Ltd?
NPPES lists Kurt Bruksch (Vice-President) as the authorized official for this organization.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2010-06-03.