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Organization
ORLAND PARK ORTHOPEDICS SC
Active
Organization
ORLAND PARK ORTHOPEDICS SC
Active
Other names
South Chicago Orthopedics
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRENT J RHODE MS (PRACTICE MANAGER)
(708) 337-7704
Entity
Organization
Contact information
Practice address
16450 S 104TH AVE, ORLAND PARK, IL 60467-5441
(708) 364-8441
(708) 364-8443
Mailing address
16450 S 104TH AVE, ORLAND PARK, IL 60467-5441
(708) 364-8441
(708) 364-8443
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
036105379
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01632642
BLUE CROSS
IL
05
—
036105379
—
IL
Enumeration date
09/07/2006
Last updated
03/07/2023
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