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Organization

ORTHOMIDWEST, PLLC

Active
Parent organization
ORTHOILLINOIS
Organization subpart
Yes

Provider details

NPI number
Legal business name
ORTHOILLINOIS
Authorized official
LESLIE ELMER CPCS (MANGAER, CREDENTIALING AND RISK)
(815) 381-7431
Entity
Organization

Contact information

Practice address
324 ROXBURY ROAD, ROCKFORD, IL 61107-5090
(815) 398-9491
(815) 381-7498
Mailing address
PO BOX 735263, CHICAGO, IL 60673-5263
(815) 398-9491
(815) 381-7498

Taxonomy

Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
207X00000X
Orthopaedic Surgery Physician
207XS0106X
Orthopaedic Hand Surgery Physician
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
207XX0801X
Orthopaedic Trauma Physician
208100000X
Physical Medicine & Rehabilitation Physician
225100000X
Physical Therapist
2251X0800X
Orthopedic Physical Therapist
225X00000X
Occupational Therapist
332B00000X
Durable Medical Equipment & Medical Supplies
335E00000X
Prosthetic/Orthotic Supplier
Primary
363A00000X
Physician Assistant

Other

Enumeration date
06/16/2006
Last updated
07/10/2026
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