Organization
ILLINOIS BONE AND JOINT INSTITUTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN DAVID WEIDNER ATC (CERTIFIED ATHLETIC TRAINER)
(847) 322-4518
Entity
Organization
Contact information
Practice address
1450 BUSCH PKWY, BUFFALO GROVE, IL 60089-4541
(224) 676-7960
Mailing address
8459 LINDER CT, SKOKIE, IL 60077-2014
(847) 322-4518
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
096.002850
IL
Other
Enumeration date
03/15/2010
Last updated
03/15/2010
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