# REGIONAL ORTHOPAEDICS & SPORTS MEDICINE CENTER, LTD.

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

## Provider details

- **NPI number:** 1609990944
- **Authorized official:** DARR W LEUTZ M.D. (PRESIDENT)
- **Authorized official phone:** (217) 243-0033

## Contact information

- **Practice address:** 1600 W WALNUT ST, JACKSONVILLE, IL 62650-1136
- **Practice address phone:** (217) 243-0033
- **Practice address fax:** (217) 245-1791
- **Mailing address:** 1600 W WALNUT ST, JACKSONVILLE, IL 62650-1136
- **Mailing address phone:** (217) 243-0033
- **Mailing address fax:** (217) 245-1791

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | 036088511 | IL | Yes |

## Other

- **Enumeration date:** 03/19/2007
- **Last updated:** 07/10/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 036088511 | — | IL |