Illinois Bone and Joint Institute, LLC

Organization Active NPI Physical Therapist · Libertyville, IL

NPI 1447318878 · NPPES record last updated Jul 21, 2022

Key facts

NPI
1447318878
Entity type
Organization (NPI type 2)
Primary specialty
Physical Therapist 225100000X
Legal business name
ILLINOIS BONE AND JOINT INSTITUTE, LLC
Practice address
724 Florsheim Dr
Libertyville, IL 60048-3757
Phone
(847) 918-9077
Fax
(847) 918-9770
NPI assigned
Dec 5, 2006
Organization subpart
No

Authorized official

Name
Wayne M Goldstein, MD
Title
President
Phone
(847) 324-3976

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IL

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20100930046089 IL DME Supplier - Independently-Practicing Physical Therapist
DME Supplier - Independently-Practicing Occupational Therapist
6002814878 Practice locations: Libertyville, IL

National Provider Directory

Tax ID family
Il Bone Joint Institute LLC (83 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist
Group: 193200000X MULTI-SPECIALTY GROUP
225100000X Yes
Occupational Therapist
Group: 193200000X MULTI-SPECIALTY GROUP
225X00000X

Addresses

Primary practice location

724 Florsheim Dr
Libertyville, IL 60048-3757

Mailing address

900 Rand Rd
Suite 300
Des Plaines, IL 60016-2359
Phone (847) 324-3976

Other providers in Libertyville, IL

All providers in Libertyville, IL · Physical Therapist in Illinois

Sources for this page

Verify at the official NPI Registry.