Organization
ORTHOPAEDIC CENTER OF SOUTHERN ILLINOIS, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER E LEHMAN (OFFICE MANAGER)
(618) 242-3778
Entity
Organization
Contact information
Practice address
4121 VETERANS MEMORIAL DR, MOUNT VERNON, IL 62864-6262
(618) 242-3778
Mailing address
4121 VETERANS MEMORIAL DR, MOUNT VERNON, IL 62864-6262
(618) 242-3778
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1134171226
TYPE 2 NPI
IL
Enumeration date
12/16/2018
Last updated
12/16/2018
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