# SUBURBAN ORTHOPAEDICS

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

## Provider details

- **NPI number:** 1063737658
- **Authorized official:** EDWARD ORTIZ (PRACTICE & COMPLIANCE ADMINISTRATOR)
- **Authorized official phone:** (630) 372-1100

## Contact information

- **Practice address:** 1600 N RANDALL RD, ELGIN, IL 60123-7800
- **Practice address phone:** (630) 372-1100
- **Practice address fax:** (630) 372-6230
- **Mailing address:** 1110 W SCHICK RD, BARTLETT, IL 60103-3007
- **Mailing address phone:** (630) 372-1100
- **Mailing address fax:** (630) 372-6230

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | 038007742 | IL | — |
| 207X00000X | Orthopaedic Surgery Physician | 036064932 | IL | Yes |
| 207XS0117X | Orthopaedic Surgery of the Spine Physician | 036097451 | IL | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | 070012618 | IL | — |
| 363A00000X | Physician Assistant | 085001660 | IL | — |
| 363A00000X | Physician Assistant | 085002852 | IL | — |

## Other

- **Enumeration date:** 04/07/2010
- **Last updated:** 09/08/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 01626816 | BCBS | IL |
| 05 | — | 036064932 | — | IL |