Illinois Bone and Joint Institute, LLC
Organization Active NPI Orthopaedic Surgery Physician · Arlington Heights, IL
NPI 1609935949 · NPPES record last updated Aug 12, 2011
Key facts
- NPI
- 1609935949
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Orthopaedic Surgery Physician 207X00000X
- Legal business name
- ILLINOIS BONE AND JOINT INSTITUTE, LLC
- Practice address
- 1300 E Central Rd
Arlington Heights, IL 60005-2857 - Phone
- (847) 870-6100
- NPI assigned
- Dec 6, 2006
- Organization subpart
- No
Authorized official
- Name
- Wayne M Goldstein, MD
- Title
- President
- Phone
- (847) 324-3976
Corporate family (same tax ID) 24
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100930062663 | IL | DME Supplier - Multi-Specialty - Physician |
6002814878 | Practice locations: Arlington Heights, IL |
National Provider Directory
- Tax ID family
- Il Bone Joint Institute LLC
Locations
5057 Paysphere Cir
Chicago, IL 60674
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician |
207X00000X | Yes |
Addresses
Primary practice location
1300 E Central Rd
Arlington Heights, IL 60005-2857
Mailing address
5057 Paysphere Cir
Chicago, IL 60674-0050
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All providers in Arlington Heights, IL · Orthopaedic Surgery Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 12, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.