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General NPI Number Information
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NPI Number | 1245230747
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Entity Type | Organization
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Legal Business Name | MARIAN ORTHOPEDIC & REHABILITATION CENTERS SC
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Dates
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Enumeration Date | 07/26/2005
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Last Update Date | 10/06/2015
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Provider Practice Location Address
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Address Line | 4849 W FULLERTON AVE
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City | CHICAGO
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State | IL
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Zip | 60639-2503
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Country | US
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Telephone | 312-326-6100
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Fax | 773-725-0097
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Provider Business Mailing Address
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Address Line | 39654 TREASURY CTR
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City | CHICAGO
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State | IL
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Zip | 60694-9000
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Country | US
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Telephone | 312-326-6100
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Fax | 773-725-0097
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN J O'KEEFE
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Credential | M.D.
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Telephone | 312-326-6100
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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 | 036061666
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License Number State | IL
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