Organization
ORTHOMIDWEST SURGERY CENTER BELOIT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LESLIE ELMER CPCS (DIRECTOR, CREDENTIALING AND RISK)
(815) 381-7431
Entity
Organization
Contact information
Practice address
2102 FREEMAN PARKWAY, BELOIT, WI 53511
(815) 398-9491
Mailing address
5875 E RIVERSIDE BLVD, ROCKFORD, IL 61114-4937
(815) 381-7431
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
08/08/2022
Last updated
06/06/2023
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