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General NPI Number Information
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NPI Number | 1124533039
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Entity Type | Organization
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Legal Business Name | REZIN ORTHOPEDIC AND SPORTS MEDICINE, SC
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Dates
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Enumeration Date | 12/14/2017
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 1312 HOUBOLT RD
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City | JOLIET
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State | IL
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Zip | 60431-9215
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Country | US
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Telephone | 815-553-2860
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Fax | 815-725-8520
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Provider Business Mailing Address
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Address Line | 1051 W US ROUTE 6 STE 100
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City | MORRIS
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State | IL
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Zip | 60450-3370
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Country | US
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Telephone | 815-942-4875
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Fax | 815-942-5046
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MICHAEL TOPIELEC
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Credential |
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Telephone | 815-942-4875
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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 | 042007183
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 042007183
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 042007183
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 042007183
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License Number State | IL
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