# MIDWEST ORTHOPEDIC SERVICES, SC

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

## Provider details

- **NPI number:** 1134361645
- **Authorized official:** JACLYN M SCOTT (PRACTICE MANAGER)
- **Authorized official phone:** (309) 341-1301

## Contact information

- **Practice address:** 834 N SEMINARY ST, SUITE 406, GALESBURG, IL 61401-2852
- **Practice address phone:** (309) 341-1301
- **Practice address fax:** (309) 341-1377
- **Mailing address:** 834 N SEMINARY ST, SUITE 406, GALESBURG, IL 61401-2852
- **Mailing address phone:** (309) 341-1301
- **Mailing address fax:** (309) 341-1377

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | 036-049846 | IL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | 036-052254 | IL | — |
| 213ES0131X | Foot Surgery Podiatrist | 016-004267 | IL | — |

## Other

- **Enumeration date:** 03/30/2009
- **Last updated:** 03/30/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 5725610001 | MEDICARE DMEPOS\# / ADMINSTAR FEDERAL | IL |