Organization
JOHN C. KEFALAS, M.D.,S.C.
Active
Other names
Central Illinois Bone and Joint Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN CHRIS KEFALAS M.D. (PRESIDENT)
(217) 425-2600
Entity
Organization
Contact information
Practice address
2905 N MAIN ST, SUITE G, DECATUR, IL 62526-4276
(217) 425-2600
(217) 425-2900
Mailing address
2905 N MAIN ST, SUITE G, DECATUR, IL 62526-4276
(217) 425-2600
(217) 425-2900
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
36-094691
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36-094691
—
IL
Enumeration date
06/28/2005
Last updated
02/13/2017
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