Organization
ORTHOPAEDIC CENTER OF IL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY A VANFLEET MD (BOARD PRESIDENT)
(217) 547-9100
Entity
Organization
Contact information
Practice address
1301 S KOKE MILL RD, SPRINGFIELD, IL 62711-9252
(217) 547-9100
Mailing address
PO BOX 9469, SPRINGFIELD, IL 62791-9469
(217) 547-9132
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
—
—
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
213E00000X
Podiatrist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CD2682
RR MEDICARE
IL
01
—
CI5139
RR MEDICARE
IL
Enumeration date
01/13/2006
Last updated
05/06/2026
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