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NPI Code Detail

MEDICARE: ORTHOMIDWEST, PLLC

MEDICARE: ORTHOMIDWEST, PLLC
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
1213E00000XPodiatrist
2225100000XPhysical Therapist
32251X0800XOrthopedic Physical Therapist
4225X00000XOccupational Therapist
5363A00000XPhysician Assistant
6208100000XPhysical Medicine & Rehabilitation Physician
7207RR0500XRheumatology Physician
8207XS0106XOrthopaedic Hand Surgery Physician
9207XX0005XSports Medicine (Orthopaedic Surgery) Physician
10207XX0801XOrthopaedic Trauma Physician
11207X00000XOrthopaedic Surgery Physician

General Provider Information

NPI Number : 1730136474
Entity Type Code : Organization
Provider Name (Legal Business Name) : ORTHOMIDWEST, PLLC
Provider Business Mailing Address
First Line : PO BOX 735263
Second Line :
City : CHICAGO
State : IL
Zip : 60673-5263
Country : US
Telephone Number : 815-398-9491
Fax Number : 815-381-7489
Provider Business Practice Location Address
First Line : 324 ROXBURY RD
Second Line :
City : ROCKFORD
State : IL
Zip : 61107-5090
Country : US
Telephone Number : 815-398-9491
Fax Number : 815-381-7498
Authorized Official
Title or Position : CREDENTIALING COORDINATOR
Name : MRS. LESLIE A ELMER
Credential :
Telephone Number : 815-381-7431
Provider Enumeration Date : 05/28/2006
Last Update Date : 01/16/2023

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Directions to “ORTHOMIDWEST, PLLC ” Practice Location

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