Organization
ORTHOMIDWEST, PLLC
Active
Other names
OrthoIllinois
Organization subpart
No
Provider details
NPI number
Authorized official
LESLIE ELMER (MANAGER, CREDENTIALING AND RISK MAN)
(815) 381-7431
Entity
Organization
Contact information
Practice address
650 S RANDALL RD, ALGONQUIN, IL 60102-5944
(815) 398-9491
Mailing address
PO BOX 735263, CHICAGO, IL 60673-5263
(181) 538-1743
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
07/06/2018
Last updated
04/19/2024
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