# MIDAMERICA ORTHOPAEDICS, S.C.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MidAmerica Hand to Shoulder Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003171596
- **Authorized official:** DR. ANTON J FAKHOURI M.D. (PRESIDENT)
- **Authorized official phone:** (708) 237-7200

## Contact information

- **Practice address:** 10330 S ROBERTS RD, PALOS HILLS, IL 60465-1971
- **Practice address phone:** (708) 237-7200
- **Practice address fax:** (708) 237-7201
- **Mailing address:** 10330 S ROBERTS RD, PALOS HILLS, IL 60465-1971
- **Mailing address phone:** (708) 237-7252
- **Mailing address fax:** (708) 237-7274

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RS0010X | Sports Medicine (Internal Medicine) Physician | 036-096721 | IL | — |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |
| 207XS0106X | Orthopaedic Hand Surgery Physician | 036-076397 | IL | — |

## Other

- **Enumeration date:** 07/10/2012
- **Last updated:** 06/27/2022