Healthcare Provider Details

I. General information

NPI: 1972472231
Provider Name (Legal Business Name): OHIO ORTHOPEDIC MANAGEMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2025
Last Update Date: 11/04/2025
Certification Date: 11/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

746 N LA SALLE DR STE 1
CHICAGO IL
60654-3200
US

IV. Provider business mailing address

746 N LA SALLE DR STE 1
CHICAGO IL
60654-3200
US

V. Phone/Fax

Practice location:
  • Phone: 312-951-8200
  • Fax:
Mailing address:
  • Phone: 312-951-8200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204C00000X
TaxonomySports Medicine (Neuromusculoskeletal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: MARC STRONGIN
Title or Position: ADMINISTRATOR
Credential:
Phone: 312-951-8200