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NPI Code Detail

MEDICARE: NORTHWEST ORTHOPEDIC SURGERY, S.C.

MEDICARE: NORTHWEST ORTHOPEDIC SURGERY, S.C.
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
1207X00000XOrthopaedic Surgery Physician42-3132IL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1716160OTHERILMEDICARE PROVIDER NUMBER

General Provider Information

NPI Number : 1720256472
Entity Type Code : Organization
Provider Name (Legal Business Name) : NORTHWEST ORTHOPEDIC SURGERY, S.C.
Provider Business Mailing Address
First Line : 1120 N ARLINGTON HEIGHTS RD
Second Line :
City : ARLINGTON HTS
State : IL
Zip : 60004-4767
Country : US
Telephone Number : 847-870-4200
Fax Number : 847-870-0059
Provider Business Practice Location Address
First Line : 1120 N ARLINGTON HEIGHTS RD
Second Line :
City : ARLINGTON HTS
State : IL
Zip : 60004-4767
Country : US
Telephone Number : 847-870-4200
Fax Number : 847-870-0059
Authorized Official
Title or Position : PRESIDENT
Name : DR. RICHARD A MANNION
Credential : MD
Telephone Number : 847-870-4200
Provider Enumeration Date : 02/15/2008
Last Update Date : 02/15/2008

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Directions to “NORTHWEST ORTHOPEDIC SURGERY, S.C. ” Practice Location

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