Orthomidwest, PLLC

Organization Active NPI Orthopaedic Surgery Physician · Algonquin, IL

NPI 1477049070 · NPPES record last updated Apr 19, 2024

Key facts

NPI
1477049070
Entity type
Organization (NPI type 2)
Primary specialty
Orthopaedic Surgery Physician 207X00000X
Legal business name
ORTHOMIDWEST, PLLC
Practice address
650 S Randall Rd
Algonquin, IL 60102-5944
Phone
(815) 398-9491
NPI assigned
Jul 6, 2018
Organization subpart
No

Authorized official

Name
Leslie Elmer
Title
Manager, Credentialing and Risk Man
Phone
(815) 381-7431

Other NPIs with the same Medicare PAC ID 22

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 28

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

View all 28

Practitioners 532

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

View all 532

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IL

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20190422001281 IL DME Supplier - Physician - Orthopedic/Orthopedic Surgery 0749183713 Practice locations: Algonquin, IL

National Provider Directory

Tax ID family
Rockford Ortho Assoc LTD (29 organizations share this tax ID)

Locations

5875 E Riverside Blvd
Rockford, IL 61114
Phone (779) 774-1270

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207X00000X Yes
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

650 S Randall Rd
Algonquin, IL 60102-5944

Mailing address

PO Box 735263
Chicago, IL 60673-5263
Phone (181) 538-1743

Other names

  • OrthoIllinois Other name

Other providers in Algonquin, IL

All providers in Algonquin, IL · Orthopaedic Surgery Physician in Illinois

Sources for this page

Verify at the official NPI Registry.