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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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