Healthcare Provider Details

I. General information

NPI: 1457590457
Provider Name (Legal Business Name): SARKIS MICHAEL BEDIKIAN D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2009
Last Update Date: 12/20/2021
Certification Date: 12/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10330 S ROBERTS RD
PALOS HILLS IL
60465-1971
US

IV. Provider business mailing address

10330 S ROBERTS RD UNIT 911
PALOS HILLS IL
60465-1971
US

V. Phone/Fax

Practice location:
  • Phone: 708-237-7200
  • Fax: 708-237-7201
Mailing address:
  • Phone: 630-965-8787
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number036121348
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number036121348
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: