Organization
WESTGATE ORTHOPAEDICS, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWARD BOONE BRACKETT III M.D. (PRESIDENT)
(708) 848-7700
Entity
Organization
Contact information
Practice address
1125 WESTGATE ST, OAK PARK, IL 60301-1007
(708) 848-7700
(708) 848-9375
Mailing address
1125 WESTGATE ST, OAK PARK, IL 60301-1007
(708) 848-7700
(708) 848-9375
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
36-37881
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036037881
—
IL
Enumeration date
03/30/2007
Last updated
08/08/2008
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