Orthopedics of Illinois - the Bone Joint and Sports Medicine Center S

NPI #1255635892 in Normal, Illinois

Provider Information

NPI Number
1255635892
Entity Type
Organization
Organization Name
Orthopedics of Illinois - the Bone Joint and Sports Medicine Center S
Primary Specialty
Orthopaedic Surgery
Enumeration Date
Dec 22, 2010
Last Updated
Jul 7, 2011

Practice Location

Address
2200 FORT JESSE RD STE 250
City
Normal
ZIP Code
61761-6290
Phone
(309) 454-1616

Authorized Official

Name
STEPHEN STOUT
Title
ADMINISTRATOR
Phone
(309) 454-1616

Specialties & Taxonomy Codes

Specialty
Orthopaedic Surgery

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