Organization
WOODFIELD ORTHOPAEDICS SPORTS MEDICINE LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERTA BAINE (OFFICE MANAGER)
(847) 301-7776
Entity
Organization
Contact information
Practice address
12525 REGENCY SQUARE PARKWAY, SUITE F, HUNTLEY, IL 60142-6500
(847) 301-7773
(847) 301-6506
Mailing address
1102 S ROSELLE RD, SCHAUMBURG, IL 60193-4081
(847) 301-7773
(847) 301-6506
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01635715
BCBS RPOVIDER NUMBER
IL
Enumeration date
02/08/2008
Last updated
02/08/2008
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