Orthopedic & Sports Medicine Center
Organization Active NPI Orthopaedic Surgery Physician · Normal, IL
NPI 1972611044 · NPPES record last updated Mar 23, 2011
Key facts
- NPI
- 1972611044
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Orthopaedic Surgery Physician 207X00000X
- License
- 042-616684 (IL)
- Legal business name
- ORTHOPEDIC & SPORTS MEDICINE CENTER
- Practice address
- 2200 Fort Jesse Rd Ste 250
Normal, IL 61761-6290 - Phone
- (309) 454-1616
- NPI assigned
- Aug 28, 2006
- Organization subpart
- No
Authorized official
- Name
- Stephen Stout
- Title
- Chief Operating Officer
- Phone
- (309) 454-1616
Practitioners 18
-
Lawrence K.C. Li, M.D.
-
Katie L Adams, OTD, OTR/L
-
Neil J. Atkins, MPT
-
Cheryl Denise Burr, P.T.
-
Heather Deloriea, PT
-
Julie Lynn Hartke, DPT
-
David L Kieser, APN, FNP
-
Edward H. Kolb, M.D.
-
Nathaniel Gage Lyons, PT, DPT
-
Joseph Kaysing Newcomer, M.D.
-
Edward Lee Ponce, PT
-
Robin Poston, OT
-
Krista J. Sheppard, DPT
-
Lori Ann Buckley, OTR
-
David Dodgin, M.D.
-
Letitia Ann Kingston, P.T.
National Provider Directory
Locations
2110 Fox Dr
Ste B
Champaign, IL 61820
Phone (217) 355-1616
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician |
207X00000X | 042-616684 | IL | Yes |
Addresses
Primary practice location
2200 Fort Jesse Rd Ste 250
Normal, IL 61761-6290
Mailing address
PO Box 1645
Bloomington, IL 61702-1645
Other providers in Normal, IL
- One to One Health
- Anand Oroskar
- Irene Ortega
- Orthopedic & Shoulder Center, S.C.
- Orthopedic & Sports Medicine Center
- Orthopedics of Illinois - the Bone Joint and Sports Medicine Center S
- Orthopedics of Illinois - the Bone, Joint, and Sports Medicine Center
- Orthoworks, S.C.
- Lori A. Osborne
- Candice J. M. Osenga
All providers in Normal, 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 Mar 23, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.