Organization
GENESIS ORTHOPEDICS & SPORTS MEDICINE LLC
Active
Parent organization
GENESIS ORTHOPEDICS & SPORTS MEDICINE LLC
Other names
Genesis Orthopedics & Sports Medicine DME
Organization subpart
Yes
Provider details
NPI number
Legal business name
GENESIS ORTHOPEDICS & SPORTS MEDICINE LLC
Authorized official
HYTHEM P SHADID (PRESIDENT)
(630) 377-1188
Entity
Organization
Contact information
Practice address
2425 W 22ND ST STE 212, OAK BROOK, IL 60523-4658
(630) 377-1188
(630) 377-7360
Mailing address
2900 FOXFIELD RD STE 102, ST CHARLES, IL 60174-5799
(630) 377-1188
(630) 377-7360
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
02/28/2018
Last updated
11/17/2023
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