Online Referral Form
Thank you for your referral!
You may refer patients to our office by downloading and filling out our Referral Form. After you have completed the form, please fax it to our main office at 847-255-6931 or e-mail at [email protected]
If you have any questions about referring patients to our practice, please contact any of our 4 offices below during our business hours
Office Hours
Monday 08:30 AM-5:00 PM
Tuesday 08:30 AM-5:00 PM
Wednesday 08:30 AM-12:00 PM
Thursday 08:30 AM-5:00 PM
Friday 07:30 AM-2:00 PM
Saturday 08:30 AM-12:00 PM
Contact Numbers
Mount Prospect Mt. Prospect IL - Associates for Oral, Maxillofacial, and Implant Surgery Phone Number 847-255-7080 Fax 847-255-6931
Chicago Chicago IL - Associates for Oral, Maxillofacial, and Implant Surgery Phone Number 773-736-3300 Fax 773-283-1515
Bartlett Bartlett IL - Associates for Oral, Maxillofacial, and Implant Surgery Phone Number 630-289-5002 Fax 630-289-5023
Elk Grove Village Elk Grove Village IL - Associates for Oral, Maxillofacial, and Implant Surgery Phone Number 847-593-0535 Fax 847-593-5134