# BONUTTI ORTHOPEDIC SERVICES LTD

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PRACTICE ACQUISITION INC
- **Other names:** Sarah Bush Lincoln Bonutti Clinic
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1285687996
- **Legal business name:** PRACTICE ACQUISITION INC
- **Authorized official:** DENNIS PLUARD (CFO & VP OF OPERATIONS)
- **Authorized official phone:** (217) 258-2102

## Contact information

- **Practice address:** 1303 W EVERGREEN AVE, SUITE 101, EFFINGHAM, IL 62401
- **Practice address phone:** (217) 342-3400
- **Practice address fax:** (217) 342-6416
- **Mailing address:** 1303 W EVERGREEN AVE STE 101, EFFINGHAM, IL 62401-1619
- **Mailing address phone:** (217) 342-3400
- **Mailing address fax:** (217) 342-6416

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | 060005120 | IL | Yes |
| 207XS0106X | Orthopaedic Hand Surgery Physician | 060005120 | IL | — |
| 207XS0117X | Orthopaedic Surgery of the Spine Physician | — | IL | — |
| 2083S0010X | Sports Medicine (Preventive Medicine) Physician | 060005120 | IL | — |
| 2083X0100X | Occupational Medicine Physician | 060005120 | IL | — |

## Other

- **Enumeration date:** 05/17/2006
- **Last updated:** 05/22/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 166708 | HEALTHLINK | IL |
| 01 | — | 2500074 | BLUECROSS BLUE SHIELD | IL |