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General NPI Number Information
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NPI Number | 1053360818
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Entity Type | Organization
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Legal Business Name | BUFFALO GROVE ORTHOPAEDIC ASSOCIATES SC
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Dates
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Enumeration Date | 05/09/2006
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Last Update Date | 04/01/2008
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Provider Practice Location Address
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Address Line | 600 W LAKE COOK RD SUITE 160
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City | BUFFALO GROVE
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State | IL
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Zip | 60089-2091
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Country | US
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Telephone | 847-520-8900
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Fax | 847-520-9190
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Provider Business Mailing Address
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Address Line | 600 W LAKE COOK RD SUITE 160
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City | BUFFALO GROVE
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State | IL
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Zip | 60089-2091
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Country | US
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Telephone | 847-520-8900
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Fax | 847-520-9190
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN N. STAMELOS
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Credential | M.D.
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Telephone | 847-520-8900
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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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