# ADULT & PEDIATRIC ORTHOPEDICS, S.C.

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

## Provider details

- **NPI number:** 1316069651
- **Authorized official:** MISS JOANNE DEGENNARO (BUSINESS OFFICE ADMINISTRATOR)
- **Authorized official phone:** (847) 634-0400

## Contact information

- **Practice address:** 50 S MILWAUKEE AVE, STE 201, LAKE VILLA, IL 60046-9471
- **Practice address phone:** (224) 372-7880
- **Practice address fax:** (224) 372-7870
- **Mailing address:** 50 S MILWAUKEE AVE STE 201, LAKE VILLA, IL 60046-5426
- **Mailing address phone:** (224) 372-7880
- **Mailing address fax:** (224) 372-7870

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | 042005991 | IL | Yes |

## Other

- **Enumeration date:** 04/06/2007
- **Last updated:** 11/05/2014