# MCDONOUGH COUNTY HOSPITAL DISTRICT

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Western Illinois Sports Medicine & Orthopedic Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093083511
- **Authorized official:** KENNY BOYD (CEO)
- **Authorized official phone:** (309) 833-4101

## Contact information

- **Practice address:** 503 E GRANT ST, MACOMB, IL 61455-3313
- **Practice address phone:** (309) 833-4101
- **Mailing address:** 503 E GRANT ST, MACOMB, IL 61455-3313

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | 0001438 | IL | Yes |

## Other

- **Enumeration date:** 12/12/2011
- **Last updated:** 12/12/2011