Midwest Orthopaedic Institute P C

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

Legal business name

MIDWEST ORTHOPAEDIC INSTITUTE P C

Practice address

2111 Midlands Court
Sycamore, IL 60178

Phone

(815) 758-0000

Fax

(815) 758-0094

NPI assigned

Mar 20, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ashley Ross

Title

Credentialing Coordinator

Phone

(815) 991-2333

Specialties & licenses 10

Addresses

Other identifiers 2

Other names 1

• Midwest Orthopaedic Institute SC Former legal business name

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Alexander M Wallin, PTA

  • Physical Therapist
  • Sycamore, IL
  • NPI 1275313991
  NPD
• Constance Balles, PTA

  • Physical Therapy Assistant
  • Sycamore, IL
  • NPI 1972845592
  NPD (past)
• Cynthia Brown, PTA

  • Physical Therapy Assistant
  • Sycamore, IL
  • NPI 1376002980
  NPD (past)
• Angela Sisson, PTA

  • Specialist
  • Sycamore, IL
  • NPI 1225370851
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1142812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1535500800000",
    "number": "1013976927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1952 ABERDEEN CT",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601783175",
            "telephone_number": "815-758-0000",
            "fax_number": "815-748-3014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2111 MIDLANDS COURT",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "60178",
            "telephone_number": "815-758-0000",
            "fax_number": "815-758-0094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST ORTHOPAEDIC INSTITUTE P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-20",
        "last_updated": "2018-08-29",
        "status": "A",
        "authorized_official_last_name": "ROSS",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "815-991-2333"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "213EP1101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "IL",
            "license": "060010536",
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "IL",
            "license": "060010536",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IN",
            "license": "060010536",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IL",
            "license": "060010536",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "1915167",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE",
            "identifier": "041032",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Midwest Orthopaedic Institute SC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Midwest Orthopaedic Institute SC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Nicole Meyers
• Stephanie N Meyn, MOT, OTR/L, LMT
• Dzejna Mezbur
• MHB Medication Management LLC
• Michele a Jurkovic
• Hannah Elizabeth Miller
• Pamela Lucille Miller
• Sean Miller, DPT
• Dennis Misoles
• Jehangir P Mistry, MD

• Orthopaedic Surgery Physician in Sycamore, IL
• Providers in Sycamore, IL by specialty
• Orthopaedic Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.