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General NPI Number Information
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NPI Number | 1043522451
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Entity Type | Organization
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Legal Business Name | AFFILIATED ORTHOPEDIC SERVICES LTD
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Dates
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Enumeration Date | 07/14/2010
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Last Update Date | 08/25/2010
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Provider Practice Location Address
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Address Line | 135 N GREENLEAF ST STE 126
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City | GURNEE
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State | IL
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Zip | 60031-3334
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Country | US
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Telephone | 847-599-9200
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Fax |
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Provider Business Mailing Address
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Address Line | 135 N GREENLEAF ST STE 126
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City | GURNEE
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State | IL
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Zip | 60031-3334
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Country | US
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Telephone | 847-599-9200
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARVIN R FETTER
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Credential | M D
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Telephone | 847-599-9200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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