Orland Park Orthopedics SC

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

036105379 Issued in IL

Legal business name

ORLAND PARK ORTHOPEDICS SC

Practice address

16450 S 104TH Ave
Orland Park, IL 60467-5441

Phone

(708) 364-8441

Fax

(708) 364-8443

NPI assigned

Sep 7, 2006

Last updated

Mar 7, 2023By 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

Mr. Brent J Rhode, MS

Title

Practice Manager

Phone

(708) 337-7704

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• South Chicago Orthopedics Former legal business name

Locations

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Orland Park Orthopedics

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Chicago, IL
  • NPI 1164621645
  NPPES parent name
• Orland Park Orthopedics SC

  • Clinic/Center
  • Peoria, IL
  • NPI 1073081436
  NPPES parent name

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1346343936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16450 S 104TH AVE",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604675441",
            "telephone_number": "708-364-8441",
            "fax_number": "708-364-8443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16450 S 104TH AVE",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604675441",
            "telephone_number": "708-364-8441",
            "fax_number": "708-364-8443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORLAND PARK ORTHOPEDICS SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-07",
        "last_updated": "2023-03-07",
        "certification_date": "2022-08-26",
        "status": "A",
        "authorized_official_last_name": "RHODE",
        "authorized_official_first_name": "BRENT",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "708-337-7704",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MS"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": "036105379",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036105379",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "01632642",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Chicago Orthopedics",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Orthopaedic Surgery Physician in Orland Park, IL
• Providers in Orland Park, 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 Mar 7, 2023; 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.