Organization
MCDONOUGH COUNTY HOSPITAL DISTRICT
Active
Other names
Western Illinois Sports Medicine & Orthopedic Center
Organization subpart
No
Provider details
NPI number
Authorized official
KENNY BOYD (CEO)
(309) 833-4101
Entity
Organization
Contact information
Practice address
503 E GRANT ST, MACOMB, IL 61455-3313
(309) 833-4101
Mailing address
503 E GRANT ST, MACOMB, IL 61455-3313
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
0001438
IL
Other
Enumeration date
12/12/2011
Last updated
12/12/2011
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