Organization
MIDWEST BONE & JOINT SURGERY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FELIX F UNGACTA M.D. (ORTHOPEDIC SURGEON)
(618) 541-1406
Entity
Organization
Contact information
Practice address
30 APEX DRIVE, SUITE #1, HIGHLAND, IL 62249-1285
(618) 654-5400
(618) 654-8700
Mailing address
30 APEX DRIVE, SUITE #1, HIGHLAND, IL 62249-1285
(618) 654-5400
(618) 654-8700
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
215632
MEDICARE GROUP PROVIDER #
IL
01
—
K45126
MEDICARE INDIVIDUAL PVDR#
IL
Enumeration date
10/01/2007
Last updated
04/14/2008
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