Adult & Pediatric Orthopedics, S.C.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

042005991 Issued in IL

Legal business name

ADULT & PEDIATRIC ORTHOPEDICS, S.C.

Practice address

50 S Milwaukee Ave
Ste 201
Lake Villa, IL 60046-9471

Phone

(224) 372-7880

Fax

(224) 372-7870

NPI assigned

Apr 6, 2007

Last updated

Nov 5, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Miss Joanne Degennaro

Title

Business Office Administrator

Phone

(847) 634-0400

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415145600000",
    "number": "1316069651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 S MILWAUKEE AVE STE 201",
            "city": "LAKE VILLA",
            "state": "IL",
            "postal_code": "600465426",
            "telephone_number": "224-372-7880",
            "fax_number": "224-372-7870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 S MILWAUKEE AVE",
            "address_2": "STE 201",
            "city": "LAKE VILLA",
            "state": "IL",
            "postal_code": "600469471",
            "telephone_number": "224-372-7880",
            "fax_number": "224-372-7870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADULT & PEDIATRIC ORTHOPEDICS, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-06",
        "last_updated": "2014-11-05",
        "status": "A",
        "authorized_official_last_name": "DEGENNARO",
        "authorized_official_first_name": "JOANNE",
        "authorized_official_title_or_position": "BUSINESS OFFICE ADMINISTRATOR",
        "authorized_official_telephone_number": "847-634-0400",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": "042005991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2014; 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.