# THE CENTER FOR ORTHOPEDIC MEDICINE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** The Center for Outpatient Medicine
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679503692
- **Authorized official:** MRS. SARAH ELLEN GARDNER (BUSINESS DIRECTOR)
- **Authorized official phone:** (309) 662-6120

## Contact information

- **Practice address:** 2502 B. EAST EMPIRE STREET, BLOOMINGTON, IL 61704
- **Practice address phone:** (309) 662-6120
- **Practice address fax:** (309) 661-0060
- **Mailing address:** 2502 B. EAST EMPIRE STREET, BLOOMINGTON, IL 61704
- **Mailing address phone:** (309) 662-6120
- **Mailing address fax:** (309) 661-0060

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 7002116 | IL | Yes |

## Other

- **Enumeration date:** 07/04/2006
- **Last updated:** 09/11/2020