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Organization

MIDWEST SPORTS MEDICINE & ORTHOPAEDIC SURGICAL SPECIALISTS, LTD.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. EUGENE LOPEZ MD (PRESIDENT)
(847) 437-9889
Entity
Organization

Contact information

Practice address
901 BIESTERFIELD RD, SUITE 300, ELK GROVE VILLAGE, IL 60007-3392
(847) 437-9889
(847) 437-4149
Mailing address
901 BIESTERFIELD RD, SUITE 300, ELK GROVE VILLAGE, IL 60007-3392
(847) 437-9889
(847) 437-4149

Taxonomy

Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
042-006737
IL
213E00000X
Podiatrist
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
31603457
BC/BS
IL
Enumeration date
07/26/2005
Last updated
06/26/2024
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