# GOLD COAST ORTHOPEDICS AND REHABILITATION, LTD

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

## Provider details

- **NPI number:** 1194887166
- **Authorized official:** DR. JACOB MORGENSTERN M.D. (OWNER)
- **Authorized official phone:** (708) 719-3527

## Contact information

- **Practice address:** 10140 191ST ST, MOKENA, IL 60448-9381
- **Practice address phone:** (708) 719-3527
- **Mailing address:** 1443 N DEARBORN ST, CHICAGO, IL 60610-1505
- **Mailing address phone:** (708) 719-3527

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | 036052805 | IL | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |

## Other

- **Enumeration date:** 12/15/2006
- **Last updated:** 02/09/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 01636549 | BLUE SHIELD | IL |
| 01 | — | 1750475349 | NPI | — |