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Organization
SOUTHLAND BONE & JOINT INSTITUTE, S.C.
Active
Organization
SOUTHLAND BONE & JOINT INSTITUTE, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WENDI L JEFFERS (OFFICE MANAGER)
(708) 283-2600
Entity
Organization
Contact information
Practice address
20060 GOVERNORS DR, SUITE 300, OLYMPIA FIELDS, IL 60461-1029
(708) 283-2600
(708) 283-1250
Mailing address
20060 GOVERNORS DR, SUITE 300, OLYMPIA FIELDS, IL 60461-1029
(708) 283-2600
(708) 283-1250
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
NULL
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01632336
BLUE SHIELD PROVIDER #
IL
05
—
200394600B
—
IN
Enumeration date
07/30/2006
Last updated
03/17/2009
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