MEDICARE: SPECIAL CARE ORTHOPEDICS & HAND SURGERY 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
1	174400000X	Specialist	036081375	IL

General Provider Information

NPI Number	:	1972629376
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPECIAL CARE ORTHOPEDICS & HAND SURGERY LTD.

Provider Business Mailing Address
First Line	:	675 W NORTH AVE STE 607
Second Line	:
City	:	MELROSE PARK
State	:	IL
Zip	:	60160-1627
Country	:	US
Telephone Number	:	708-681-7809
Fax Number	:	708-681-7808

Provider Business Practice Location Address
First Line	:	675 W NORTH AVE STE 607
Second Line	:
City	:	MELROSE PARK
State	:	IL
Zip	:	60160-1627
Country	:	US
Telephone Number	:	708-681-7809
Fax Number	:	708-681-7808

Authorized Official
Title or Position	:	PRACTICE MANAGER
Name	:	MRS. TINA L SCHRADER
Credential	:
Telephone Number	:	708-681-7809

Provider Enumeration Date	:	03/21/2007
Last Update Date	:	04/22/2010

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