Healthcare Provider Details

I. General information

NPI: 1306222070
Provider Name (Legal Business Name): INTEGRITY ORTHOPEDICS AND PAIN LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2015
Last Update Date: 08/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

908 N ELM ST SUITE 109
HINSDALE IL
60521-3635
US

IV. Provider business mailing address

PO BOX 388328
CHICAGO IL
60638-8328
US

V. Phone/Fax

Practice location:
  • Phone: 773-767-3822
  • Fax: 773-337-9106
Mailing address:
  • Phone: 773-767-3822
  • Fax: 773-337-9106

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number036082067
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number036082067
License Number StateIL

VIII. Authorized Official

Name: LYNNETTE MCROY
Title or Position: BILLING COORDINATOR
Credential:
Phone: 773-767-3822