Organization
SUBURBAN ORTHOPAEDICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD ORTIZ (PRACTICE & COMPLIANCE ADMINISTRATOR)
(630) 372-1100
Entity
Organization
Contact information
Practice address
1600 N RANDALL RD, ELGIN, IL 60123-7800
(630) 372-1100
(630) 372-6230
Mailing address
1110 W SCHICK RD, BARTLETT, IL 60103-3007
(630) 372-1100
(630) 372-6230
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
038007742
IL
207X00000X
Orthopaedic Surgery Physician
Primary
036064932
IL
207XS0117X
Orthopaedic Surgery of the Spine Physician
036097451
IL
208100000X
Physical Medicine & Rehabilitation Physician
070012618
IL
363A00000X
Physician Assistant
085001660
IL
363A00000X
Physician Assistant
085002852
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01626816
BCBS
IL
05
—
036064932
—
IL
Enumeration date
04/07/2010
Last updated
09/08/2023
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