Organization
ORTHOPEDIC, SPORTS & REHABILITATION CENTER, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TARA NIGAM M.D. (OWNER)
(815) 397-6276
Entity
Organization
Contact information
Practice address
6957 OLDE CREEK RD, SUITE #3400, ROCKFORD, IL 61114-7416
(815) 397-6276
(815) 397-2266
Mailing address
6957 OLDE CREEK RD, SUITE #3400, ROCKFORD, IL 61114-7416
(815) 397-6276
(815) 397-2266
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
IL
208100000X
Physical Medicine & Rehabilitation Physician
—
IL
Other
Enumeration date
07/24/2007
Last updated
02/15/2008
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