NPIMap

Organization Active NPI

Iroquois Memorial Hospital

Doing business as Iroquois Orthopedics

  • Orthopaedic Surgery Physician
  • Watseka, IL
National Provider Identifier
1942454947
Registry record updated Nov 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
IROQUOIS MEMORIAL HOSPITAL
Doing business as
Iroquois Orthopedics
Practice address
200 E Fairman Ave
Watseka, IL 60970-1644
Phone
(815) 432-7770
Fax
(815) 432-7824
NPI assigned
Nov 5, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2008

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

Authorized official

Name
Stephen O Leurck
Title
Ceo
Phone
(815) 432-7736

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X Primary

Addresses

Primary practice location

200 E Fairman Ave
Watseka, IL 60970-1644

Mailing address

200 E Fairman Ave
Watseka, IL 60970-1644
Phone (815) 432-7770

Other names 1

  • Iroquois Orthopedics Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040517000306 IL Part B Supplier - Clinic/Group Practice 4385551258 Receives reassigned benefits from 75 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Saint Anne, IL; Watseka, IL

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Iroquois Memorial Hospi15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1225843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225843200000",
    "number": "1942454947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E FAIRMAN AVE",
            "city": "WATSEKA",
            "state": "IL",
            "postal_code": "609701644",
            "telephone_number": "815-432-7770",
            "fax_number": "815-432-7824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E FAIRMAN AVE",
            "city": "WATSEKA",
            "state": "IL",
            "postal_code": "609701644",
            "telephone_number": "815-432-7770",
            "fax_number": "815-432-7824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IROQUOIS MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-05",
        "last_updated": "2008-11-05",
        "status": "A",
        "authorized_official_last_name": "LEURCK",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "815-432-7736"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Iroquois Orthopedics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Watseka, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2008; 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.