MEDICARE: MICHAEL R O'ROURKE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	036-106444	IL

General Provider Information

NPI Number	:	1053306316
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL R O'ROURKE MD

Provider Business Mailing Address
First Line	:	900 RAND RD STE 300
Second Line	:	ATTN: RAQUEL LEON
City	:	DES PLAINES
State	:	IL
Zip	:	60016-2359
Country	:	US
Telephone Number	:	847-324-3976
Fax Number	:

Provider Business Practice Location Address
First Line	:	2401 RAVINE WAY
Second Line	:	SUITE 200
City	:	GLENVIEW
State	:	IL
Zip	:	60025-7645
Country	:	US
Telephone Number	:	847-998-5680
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/13/2005
Last Update Date	:	08/28/2012

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