Organization
MIDAMERICA ORTHOPAEDICS, S.C.
Active
Other names
MidAmerica Hand to Shoulder Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTON J FAKHOURI M.D. (PRESIDENT)
(708) 237-7200
Entity
Organization
Contact information
Practice address
19065 HICKORY CREEK DR, SUITE 210, MOKENA, IL 60448-8507
(708) 237-7200
(815) 838-0590
Mailing address
19065 HICKORY CREEK DR, SUITE 210, MOKENA, IL 60448-8507
(708) 237-7200
(815) 838-0590
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
036-084909
IL
2082S0105X
Surgery of the Hand (Plastic Surgery) Physician
036-095853
IL
Other
Enumeration date
06/26/2012
Last updated
06/26/2012
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