# ORLAND PARK ORTHOPEDICS SC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** South Chicago Orthopedics
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346343936
- **Authorized official:** MR. BRENT J RHODE MS (PRACTICE MANAGER)
- **Authorized official phone:** (708) 337-7704

## Contact information

- **Practice address:** 16450 S 104TH AVE, ORLAND PARK, IL 60467-5441
- **Practice address phone:** (708) 364-8441
- **Practice address fax:** (708) 364-8443
- **Mailing address:** 16450 S 104TH AVE, ORLAND PARK, IL 60467-5441
- **Mailing address phone:** (708) 364-8441
- **Mailing address fax:** (708) 364-8443

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | 036105379 | IL | Yes |

## Other

- **Enumeration date:** 09/07/2006
- **Last updated:** 03/07/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 01632642 | BLUE CROSS | IL |
| 05 | — | 036105379 | — | IL |