MEDICARE: ILLINOIS BONE AND JOINT INSTITUTE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1043027642
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ILLINOIS BONE AND JOINT INSTITUTE, LLC

Provider Business Mailing Address
First Line	:	900 RAND RD STE 300
Second Line	:
City	:	DES PLAINES
State	:	IL
Zip	:	60016-2359
Country	:	US
Telephone Number	:	847-324-3976
Fax Number	:	847-929-1154

Provider Business Practice Location Address
First Line	:	3030 W SALT CREEK LN STE 160
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60005-5005
Country	:	US
Telephone Number	:	847-670-5840
Fax Number	:	847-870-0059

Authorized Official
Title or Position	:	CRED MANAGER
Name	:	RAQUEL LEON
Credential	:
Telephone Number	:	847-324-3976

Provider Enumeration Date	:	12/17/2024
Last Update Date	:	07/09/2025

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