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General NPI Number Information
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NPI Number | 1881484681
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Entity Type | Organization
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Legal Business Name | ILLINOIS BONE AND JOINT INSTITUTE, LLC
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Dates
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Enumeration Date | 05/07/2025
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Last Update Date | 05/07/2025
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Provider Practice Location Address
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Address Line | 202 S GREENLEAF ST STE 202-F
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City | GURNEE
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State | IL
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Zip | 60031-3399
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Country | US
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Telephone | 847-336-3335
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Fax | 847-336-3249
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Provider Business Mailing Address
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Address Line | 900 RAND RD STE 300
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City | DES PLAINES
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State | IL
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Zip | 60016-2359
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Country | US
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Telephone | 847-324-3976
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Fax | 847-929-1154
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Authorized Official
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Title or Position | CRED MANAGER
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Name | RAQUEL LEON
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Credential |
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Telephone | 847-324-3976
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number |
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License Number State |
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