Healthcare Provider Details

I. General information

NPI: 1083613368
Provider Name (Legal Business Name): LITCHFIELD ORTHOPEDIC & SPORTS MEDICINE CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 SAINT FRANCIS WAY
LITCHFIELD IL
62056-1780
US

IV. Provider business mailing address

725 SAINT FRANCIS WAY
LITCHFIELD IL
62056-1780
US

V. Phone/Fax

Practice location:
  • Phone: 217-324-4233
  • Fax: 217-324-8622
Mailing address:
  • Phone: 217-324-4233
  • Fax: 217-324-8622

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateIL

VIII. Authorized Official

Name: DR. JOHN E STIRNAMAN
Title or Position: ORTHOPEDIC SURGEON
Credential: M.D.
Phone: 618-462-1201