# ILLINOIS BONE AND JOINT INSTITUTE, LLC

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

## Provider details

- **NPI number:** 1669004610
- **Authorized official:** WAYNE GOLDSTEIN (PRESIDENT)
- **Authorized official phone:** (847) 324-3976

## Contact information

- **Practice address:** 400 S KENNEDY DR STE 100, BRADLEY, IL 60915-2685
- **Practice address phone:** (815) 928-8050
- **Practice address fax:** (815) 928-8932
- **Mailing address:** 900 RAND RD STE 300, DES PLAINES, IL 60016-2359
- **Mailing address phone:** (847) 324-3976
- **Mailing address fax:** (847) 929-1154

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |
| 225100000X | Physical Therapist | — | NULL | — |
| 225100000X | Physical Therapist | — | — | — |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | — | — | — |

## Other

- **Enumeration date:** 02/07/2020
- **Last updated:** 02/07/2020