Healthcare Provider Details

I. General information

NPI: 1336450030
Provider Name (Legal Business Name): PARKVIEW ORTHOPAEDIC GROUP S C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2010
Last Update Date: 11/19/2024
Certification Date: 11/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 GLENWOOD AVE STE 220
JOLIET IL
60435-5498
US

IV. Provider business mailing address

7600 W COLLEGE DR
PALOS HEIGHTS IL
60463-1001
US

V. Phone/Fax

Practice location:
  • Phone: 815-729-3939
  • Fax: 815-463-8268
Mailing address:
  • Phone: 708-361-0600
  • Fax: 708-923-2529

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number042619645
License Number StateIL

VIII. Authorized Official

Name: MARIA FLAMBURIS
Title or Position: REVENUE CYCLE MANAGER
Credential:
Phone: 708-361-0600