# ILLINOIS SPORTS MEDICINE & ORTHOPEDIC SURGERY CENTER, LLC

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

## Provider details

- **NPI number:** 1710037452
- **Authorized official:** LETICIA A RAMIREZ RN, MBA (ADMINISTRATOR)
- **Authorized official phone:** (773) 762-9359

## Contact information

- **Practice address:** 9000 WAUKEGAN RD, SUITE 120, MORTON GROVE, IL 60053-2127
- **Practice address phone:** (847) 213-5444
- **Practice address fax:** (847) 213-5499
- **Mailing address:** 9000 WAUKEGAN RD STE 120, MORTON GROVE, IL 60053-2128
- **Mailing address phone:** (847) 213-5444
- **Mailing address fax:** (847) 213-5499

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 7003118 | IL | Yes |

## Other

- **Enumeration date:** 01/12/2007
- **Last updated:** 09/02/2026