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Organization

ORTHOMIDWEST, PLLC

Active
Other names
OrthoIllinois
Organization subpart
No

Provider details

NPI number
Authorized official
LESLIE ELMER CPCS (CREDENTIALING COORDINATOR)
(815) 381-7431
Entity
Organization

Contact information

Practice address
770 BELOIT RD, BELVIDERE, IL 61008-1745
(815) 381-7431
(815) 381-7333
Mailing address
PO BOX 735263, CHICAGO, IL 60673-5263
(815) 381-7431
(815) 381-7333

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
060010825
IL

Other

Enumeration date
07/15/2016
Last updated
04/19/2024
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