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General NPI Number Information
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NPI Number | 1689153140
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Entity Type | Organization
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Legal Business Name | GITELIS ORTHOPEDICS LTD
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Dates
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Enumeration Date | 08/07/2018
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 27401 W IL ROUTE 22 STE 6
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City | BARRINGTON
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State | IL
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Zip | 60010-5999
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Country | US
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Telephone | 847-807-7770
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Fax | 847-807-7771
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Provider Business Mailing Address
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Address Line | 1800 MCDONOUGH RD STE 202
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City | HOFFMAN ESTATES
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State | IL
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Zip | 60192-4565
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Country | US
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Telephone | 847-807-7770
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Fax | 847-807-7771
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | KASSANDRA CUNNINGHAM
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Credential |
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Telephone | 847-807-7770
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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 | 036055465
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License Number State | IL
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