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NPI Code Detail

MEDICARE: BERWYN ORTHOPEDIC SURGEONS, LTD.

MEDICARE: BERWYN ORTHOPEDIC SURGEONS, LTD.
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
1207X00000XOrthopaedic Surgery Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10160977859OTHERILBLUE CROSS / BLUE SHIELD

General Provider Information

NPI Number : 1588639769
Entity Type Code : Organization
Provider Name (Legal Business Name) : BERWYN ORTHOPEDIC SURGEONS, LTD.
Provider Business Mailing Address
First Line : 1730 PARK ST
Second Line : SUITE 101
City : NAPERVILLE
State : IL
Zip : 60563-2688
Country : US
Telephone Number : 630-718-0200
Fax Number : 630-718-0900
Provider Business Practice Location Address
First Line : 3231 EUCLID AVE
Second Line :
City : BERWYN
State : IL
Zip : 60402-3471
Country : US
Telephone Number : 708-484-1530
Fax Number : 708-788-1571
Authorized Official
Title or Position : PHYSICIAN OWNER
Name : DR. ASOK K RAY
Credential : M.D.
Telephone Number : 630-718-0200
Provider Enumeration Date : 02/21/2006
Last Update Date : 08/22/2020

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Directions to “BERWYN ORTHOPEDIC SURGEONS, LTD. ” Practice Location

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