Western Illinois Sports Medicine and Orthopedic Center

NPI #1558496265 in Quincy, Illinois

Provider Information

NPI Number: 1558496265
Entity Type: Organization
Organization Name: Western Illinois Sports Medicine and Orthopedic Center
Primary Specialty: Specialist
Enumeration Date: Feb 22, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 927 BROADWAY ST STE 104
City: Quincy
State: Illinois
ZIP Code: 62301-2728
Phone: (217) 224-8955

Authorized Official

Name: RONALD DEE WHEELER, M.D.
Title: PRESIDENT
Phone: (217) 224-8955

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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