# ORTHOPEDIC, SPORTS & REHABILITATION CENTER, LTD.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023218260
- **Authorized official:** TARA NIGAM M.D. (OWNER)
- **Authorized official phone:** (815) 397-6276

## Contact information

- **Practice address:** 6957 OLDE CREEK RD, SUITE \#3400, ROCKFORD, IL 61114-7416
- **Practice address phone:** (815) 397-6276
- **Practice address fax:** (815) 397-2266
- **Mailing address:** 6957 OLDE CREEK RD, SUITE \#3400, ROCKFORD, IL 61114-7416
- **Mailing address phone:** (815) 397-6276
- **Mailing address fax:** (815) 397-2266

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | IL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | IL | — |

## Other

- **Enumeration date:** 07/24/2007
- **Last updated:** 02/15/2008