Organization Active NPI

Orthomidwest, PLLC

Doing business as OrthoIllinois

  • Physical Therapy Clinic/Center
  • Elgin, IL
National Provider Identifier
1841571999
Registry record updated Apr 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
ORTHOMIDWEST, PLLC
Doing business as
OrthoIllinois
Practice address
1550 N Randall Rd
Elgin, IL 60123-7876
Phone
(815) 398-9491
Fax
(815) 381-7498
NPI assigned
Sep 2, 2011
Last updated
Apr 19, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2024

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

Authorized official

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X NU Primary
Durable Medical Equipment & Medical Supplies 332B00000X NU

Addresses

Primary practice location

1550 N Randall Rd
Elgin, IL 60123-7876

Mailing address

PO Box 735263
Chicago, IL 60673-5263
Phone (815) 398-9491

Other names 1

  • OrthoIllinois Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180625001320 IL DME Supplier - Physician - Orthopedic/Orthopedic Surgery 0749183713 Practice locations: Elgin, IL

Other NPIs with the same Medicare PAC ID 22

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

View all 22

National Provider Directory

National Provider Directory
Tax ID family
Rockford Orthopedic Ass29 organizations share this tax ID, including this one

Other organizations with this tax ID 28

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

View all 28

Locations

1435 N Randall Rd
Ste 103
Elgin, IL 60123
Phone (847) 888-0750

1550 N Randall Rd
Elgin, IL 60123
Phone (815) 569-6355

Practitioners & affiliated clinicians

Practitioners 2

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": "1314921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713484800000",
    "number": "1841571999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735263",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735263",
            "telephone_number": "815-398-9491",
            "fax_number": "815-381-7498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 N RANDALL RD",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601237876",
            "telephone_number": "815-398-9491",
            "fax_number": "815-381-7498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOMIDWEST, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-02",
        "last_updated": "2024-04-19",
        "certification_date": "2024-04-19",
        "status": "A",
        "authorized_official_last_name": "ELMER",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_title_or_position": "MANAGER, CREDENTIALING AND RISK MAN",
        "authorized_official_telephone_number": "815-381-7431"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OrthoIllinois",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elgin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.