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General NPI Number Information
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NPI Number | 1972629376
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Entity Type | Organization
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Legal Business Name | SPECIAL CARE ORTHOPEDICS & HAND SURGERY LTD.
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Dates
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Enumeration Date | 03/21/2007
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Last Update Date | 04/22/2010
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Provider Practice Location Address
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Address Line | 675 W NORTH AVE STE 607
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City | MELROSE PARK
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State | IL
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Zip | 60160-1627
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Country | US
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Telephone | 708-681-7809
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Fax | 708-681-7808
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Provider Business Mailing Address
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Address Line | 675 W NORTH AVE STE 607
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City | MELROSE PARK
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State | IL
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Zip | 60160-1627
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Country | US
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Telephone | 708-681-7809
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Fax | 708-681-7808
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MRS. TINA L SCHRADER
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Credential |
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Telephone | 708-681-7809
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 036081375
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License Number State | IL
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