Westgate Orthopaedics, LTD.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

36-37881 Issued in IL

Legal business name

WESTGATE ORTHOPAEDICS, LTD.

Practice address

1125 Westgate St
Oak Park, IL 60301-1007

Phone

(708) 848-7700

Fax

(708) 848-9375

NPI assigned

Mar 30, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Edward Boone Brackett III, M.D.

Title

President

Phone

(708) 848-7700

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218153600000",
    "number": "1639299712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 WESTGATE ST",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011007",
            "telephone_number": "708-848-7700",
            "fax_number": "708-848-9375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 WESTGATE ST",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011007",
            "telephone_number": "708-848-7700",
            "fax_number": "708-848-9375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTGATE ORTHOPAEDICS, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-30",
        "last_updated": "2008-08-08",
        "status": "A",
        "authorized_official_last_name": "BRACKETT",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "BOONE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-848-7700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": "36-37881",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036037881",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2008; 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.