Organization
MIDWEST INTEGRATED SURGEONS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LESLIE ELMER (MANAGER, CREDENTIALING AND RISK MAN)
(815) 381-7431
Entity
Organization
Contact information
Practice address
5875 E RIVERSIDE BLVD, ROCKFORD, IL 61114-4937
(815) 381-7431
Mailing address
5875 E RIVERSIDE BLVD, ROCKFORD, IL 61114-4937
(815) 381-7431
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Enumeration date
06/15/2019
Last updated
09/04/2019
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