Organization
VAN ORTHOPAEDIC & SPINE SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALLEN U VAN MD (PRESIDENT)
(815) 561-1708
Entity
Organization
Contact information
Practice address
422 CHERRY AVE, ROCHELLE, IL 61068
(815) 561-1708
(815) 561-8209
Mailing address
422 CHERRY AVE, ROCHELLE, IL 61068
(815) 561-1708
(815) 561-8209
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7126180
BCBS
IL
Enumeration date
08/24/2007
Last updated
08/24/2007
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