Organization
ORTHOMIDWEST, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LESLIE ELMER (CREDENTIALING AND RISK MANAGER)
(815) 381-7431
Entity
Organization
Contact information
Practice address
12376 PRINCETON DR, HUNTLEY, IL 60142-7655
(815) 398-9491
Mailing address
5875 E RIVERSIDE BLVD, ROCKFORD, IL 61114-4937
(815) 381-7431
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
11/24/2021
Last updated
09/12/2023
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