Organization
ORTHOMIDWEST, PLLC
Active
Other names
OrthoIllinois
Organization subpart
No
Provider details
NPI number
Authorized official
LESLIE ELMER CPCS (CREDENTIALING COORDINATOR)
(815) 381-7431
Entity
Organization
Contact information
Practice address
330 E MAIN ST, ROCKTON, IL 61072-2501
(815) 381-7431
(815) 381-7333
Mailing address
5875 E RIVERSIDE BLVD, ROCKFORD, IL 61114-4937
(815) 381-7431
(815) 381-7333
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
060010709
IL
Other
Enumeration date
07/15/2016
Last updated
01/20/2023
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