NPIMap

Organization Active NPI

Keystone Orthopedic Specialists S C

  • Orthopaedic Surgery Physician
  • Hazel Crest, IL
National Provider Identifier
1528020559
Registry record updated Aug 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
KEYSTONE ORTHOPEDIC SPECIALISTS S C
Practice address
3330 West 177TH St
Suite 2C
Hazel Crest, IL 60429
Phone
(708) 799-1144
Fax
(708) 799-4899
NPI assigned
Apr 5, 2006
Last updated
Aug 18, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2016

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

Authorized official

Name
Martin HallNPI 1205898194
Title
Owner
Phone
(708) 799-1144

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X Primary
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X 036074003 IL
PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213E00000X
Surgical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AS0400X

Addresses

Primary practice location

3330 West 177TH St
Suite 2C
Hazel Crest, IL 60429

Mailing address

3330 West 177TH St
Suite 2C
Hazel Crest, IL 60429
Phone (708) 799-1144

National Provider Directory

National Provider Directory

Locations

110 Ridge Rd
Ste 2
Munster, IN 46321
Phone (219) 834-4123

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1144195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471478400000",
    "number": "1528020559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3330 WEST 177TH ST",
            "address_2": "SUITE 2C",
            "city": "HAZEL CREST",
            "state": "IL",
            "postal_code": "60429",
            "telephone_number": "708-799-1144",
            "fax_number": "708-799-4899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 WEST 177TH ST",
            "address_2": "SUITE 2C",
            "city": "HAZEL CREST",
            "state": "IL",
            "postal_code": "60429",
            "telephone_number": "708-799-1144",
            "fax_number": "708-799-4899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEYSTONE ORTHOPEDIC SPECIALISTS S C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-05",
        "last_updated": "2016-08-18",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-799-1144"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IL",
            "license": "036074003",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazel Crest, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2016; 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.