Healthcare Provider Details

I. General information

NPI: 1144274606
Provider Name (Legal Business Name): SOUTHWEST ORTHOPEDICS, S.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 10/04/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9618 SOUTHWEST HWY
OAK LAWN IL
60453-2862
US

IV. Provider business mailing address

9618 SOUTHWEST HWY
OAK LAWN IL
60453-2862
US

V. Phone/Fax

Practice location:
  • Phone: 708-229-0101
  • Fax: 708-229-0090
Mailing address:
  • Phone: 708-229-0101
  • Fax: 708-229-0090

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number StateIL

VIII. Authorized Official

Name: HARUN DURUDOGAN
Title or Position: PRESIDENT
Credential: D.O.
Phone: 708-229-0101