# AFFILIATED ORTHOPEDIC SERVICES LTD

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Lake County Orthopedic And Sports Medicine
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043522451
- **Authorized official:** DR. MARVIN R FETTER M D (PRESIDENT)
- **Authorized official phone:** (847) 599-9200

## Contact information

- **Practice address:** 135 N GREENLEAF ST STE 126, GURNEE, IL 60031-3334
- **Practice address phone:** (847) 599-9200
- **Mailing address:** 135 N GREENLEAF ST STE 126, GURNEE, IL 60031-3334
- **Mailing address phone:** (847) 599-9200

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/14/2010
- **Last updated:** 08/25/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 03604536 | — | IL |
| 05 | — | 34444000 | — | WI |