Organization
AFFILIATED ORTHOPEDIC SERVICES LTD
Active
Other names
Lake County Orthopedic And Sports Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARVIN R FETTER M D (PRESIDENT)
(847) 599-9200
Entity
Organization
Contact information
Practice address
135 N GREENLEAF ST STE 126, GURNEE, IL 60031-3334
(847) 599-9200
Mailing address
135 N GREENLEAF ST STE 126, GURNEE, IL 60031-3334
(847) 599-9200
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03604536
—
IL
05
—
34444000
—
WI
Enumeration date
07/14/2010
Last updated
08/25/2010
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