# WOODFIELD ORTHOPAEDICS SPORTS MEDICINE LTD

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

## Provider details

- **NPI number:** 1750569059
- **Authorized official:** ROBERTA BAINE (OFFICE MANAGER)
- **Authorized official phone:** (847) 301-7776

## Contact information

- **Practice address:** 12525 REGENCY SQUARE PARKWAY, SUITE F, HUNTLEY, IL 60142-6500
- **Practice address phone:** (847) 301-7773
- **Practice address fax:** (847) 301-6506
- **Mailing address:** 1102 S ROSELLE RD, SCHAUMBURG, IL 60193-4081
- **Mailing address phone:** (847) 301-7773
- **Mailing address fax:** (847) 301-6506

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | IL | Yes |

## Other

- **Enumeration date:** 02/08/2008
- **Last updated:** 02/08/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 01635715 | BCBS RPOVIDER NUMBER | IL |