Organization
SUBURBAN ORTHOPAEDICS LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD ORTIZ (PRACTICE & COMPLIANCE ADMINISTRATOR)
(630) 372-1100
Entity
Organization
Contact information
Practice address
1110 W SCHICK RD, BARTLETT, IL 60103-3007
(630) 483-0852
Mailing address
1110 W SCHICK RD, BARTLETT, IL 60103-3007
(630) 483-0852
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
036064932
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01626816
BLUE CROSS BLUE SHIELD
—
05
—
036064932
—
IL
Enumeration date
02/18/2015
Last updated
09/08/2023
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