Organization
PREMIER MEDICAL GROUP, LLC
Active
Other names
Premier Orthopedics, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JUDY M MATENS (CREDENTIALLING ADMINISTRATOR)
(309) 662-6200
Entity
Organization
Contact information
Practice address
2005 JACOBSSEN DR, SUITE A, NORMAL, IL 61761-6287
(309) 807-2233
(309) 888-3174
Mailing address
2005 JACOBSSEN DR, SUITE A, NORMAL, IL 61761-6287
(309) 807-2233
(309) 888-3174
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
36-098056
IL
Other
Enumeration date
05/06/2011
Last updated
05/06/2011
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