Skyline Orthopedics, LLC
Organization Active NPI Orthopaedic Surgery Physician · Orland Park, IL
NPI 1962012344 · NPPES record last updated Sep 22, 2020
Key facts
- NPI
- 1962012344
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Orthopaedic Surgery Physician 207X00000X
- Legal business name
- SKYLINE ORTHOPEDICS, LLC
- Practice address
- 10811 W 143Rd St Ste 150
Orland Park, IL 60467-1945 - Phone
- (708) 405-8600
- NPI assigned
- Jul 31, 2020
- Organization subpart
- No
Authorized official
- Name
- Dr. Jonathan Watson, MD
- Title
- Physician/Owner
- Phone
- (773) 203-3894
Practitioners 6
-
Jonathan Watson, M.D.
-
George W. Cachares, PT.,MS.
-
Kassidy Rae Falduto, PA-C
-
Mary A Geimer Oneil, PHYSICAL THEREPIST
-
Adam Halim, PT, DPT
-
Jacob Stelter, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in IL, IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200911001281 | IL | Part B Supplier - Clinic/Group Practice | 5597183269 |
Receives reassigned benefits from 6 practitioners Practice locations: Orland Park, IL |
| O20201012001825 | IL | DME Supplier - Physician - Orthopedic/Orthopedic Surgery | 5597183269 | Practice locations: Orland Park, IL |
| O20250327001619 | IN | Part B Supplier - Clinic/Group Practice | 5597183269 |
Receives reassigned benefits from 2 practitioners Practice locations: Munster, IN |
National Provider Directory
Locations
10811 W 143rd St
Ste 150
Orland Park, IL 60467
Phone (708) 405-8600
9200 Calumet Ave
Ste N300
Munster, IN 46321
Phone (219) 273-2570
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician |
207X00000X | Yes |
Addresses
Primary practice location
10811 W 143Rd St Ste 150
Orland Park, IL 60467-1945
Mailing address
10811 W 143Rd St Ste 150
Orland Park, IL 60467-1945
Phone (708) 405-8600
Other practice location 1
747 E Boughton Rd # 246
Bolingbrook, IL 60440-2281
Phone (773) 203-3894
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285861435 | Other | IL | NPI |
Other providers in Orland Park, IL
- Christina Siwa
- Shelley Skas
- Anthony Michael Skelly
- Ivana Skokna
- Helen Skrzecz
- Skyrose Clinical & Consultant SVCS.
- Skyrose Rejuvenation Clinic & Spa LLC
- Jessica Slager
- Joan Teresa Slawinski
- Angelica Maria Sloan
All providers in Orland Park, 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 Sep 22, 2020. 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.