# ORTHOPAEDIC CENTER OF IL

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

## Provider details

- **NPI number:** 1154300572
- **Authorized official:** TIMOTHY A VANFLEET MD (BOARD PRESIDENT)
- **Authorized official phone:** (217) 547-9100

## Contact information

- **Practice address:** 1301 S KOKE MILL RD, SPRINGFIELD, IL 62711-9252
- **Practice address phone:** (217) 547-9100
- **Mailing address:** PO BOX 9469, SPRINGFIELD, IL 62791-9469
- **Mailing address phone:** (217) 547-9132

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207T00000X | Neurological Surgery Physician | — | NULL | — |
| 207T00000X | Neurological Surgery Physician | — | — | — |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | — |
| 213E00000X | Podiatrist | — | NULL | — |
| 213E00000X | Podiatrist | — | — | — |

## Other

- **Enumeration date:** 01/13/2006
- **Last updated:** 05/06/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | CD2682 | RR MEDICARE | IL |
| 01 | — | CI5139 | RR MEDICARE | IL |