Organization
ORTHOPEDIC & SHOULDER CENTER, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDI MEISNER (ADMINISTRATOR)
(309) 888-9800
Entity
Organization
Contact information
Practice address
2200 FORT JESSE RD STE 250, NORMAL, IL 61761-6290
(309) 454-1616
(309) 454-5167
Mailing address
2200 FORT JESSE ROAD, SUITE 250, NORMAL, IL 61761
(309) 888-9800
(309) 828-9700
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
036092458
IL
Other
Enumeration date
12/22/2010
Last updated
04/21/2015
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