Healthcare Provider Details

I. General information

NPI: 1679714547
Provider Name (Legal Business Name): SOUTHLAND ORTHOPAEDICS LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2009
Last Update Date: 12/23/2021
Certification Date: 12/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20060 GOVERNORS DR STE 300
OLYMPIA FIELDS IL
60461-1099
US

IV. Provider business mailing address

20060 GOVERNORS DR STE 300
OLYMPIA FIELDS IL
60461-1099
US

V. Phone/Fax

Practice location:
  • Phone: 708-283-2600
  • Fax: 708-283-1250
Mailing address:
  • Phone: 708-283-2600
  • Fax: 708-283-1250

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. RAM ARIBINDI
Title or Position: PRESIDENT
Credential:
Phone: 708-369-7599