Patient Registration

You may preregister with our office by filling out our secure online Patient Registration Form. After you have completed the form, please make sure to press the Submit button at the bottom to automatically send us your information. On your first visit to our office, we will have your completed form available for your signature. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.

Your Chicago Oral Surgeons at Associates for Oral, Maxillofacial & Implant Surgery LTD Proudly Offers the Following Oral Surgery Services:

Dental Implants, Wisdom Teeth Extraction, Jaw Surgery,Bone Grafting, Impacted Teeth, and Reconstructive Surgery

Serving the Greater Chicago Area and Cook County with offices in the following Illinois communities:

Chicago IL, Mount Prospect IL, Bartlett IL, Elk Grove Village IL

Associates for Oral, Maxillofacial & Implant Surgery LTD

Chicago Office: 4935-37 West Irving Park Road • Chicago, IL 60641 • Phone: 773-736-3300 • Fax: 773-283-1515

Mount Prospect Office: 10 North Ridge Avenue • Mount Prospect, IL 60056 • Phone: 847-255-7080 • Fax: 847-225-6931

Bartlett Office: 112 North Oak Avenue • Bartlett, IL 60103 • Phone: 630-289-5002 • Fax:630-289-5023

Elk Grove Village Office: 800 Biesterfield Road, Ste 3010 • Elk Grove Village, IL 60007 • Phone: 847-593-0535 • Fax: 847-593-5134