Provider Demographics
NPI:1083613368
Name:LITCHFIELD ORTHOPEDIC & SPORTS MEDICINE CLINIC
Entity Type:Organization
Organization Name:LITCHFIELD ORTHOPEDIC & SPORTS MEDICINE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHOPEDIC SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:E
Authorized Official - Last Name:STIRNAMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:618-462-1201
Mailing Address - Street 1:725 SAINT FRANCIS WAY
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62056-1780
Mailing Address - Country:US
Mailing Address - Phone:217-324-4233
Mailing Address - Fax:217-324-8622
Practice Address - Street 1:725 SAINT FRANCIS WAY
Practice Address - Street 2:
Practice Address - City:LITCHFIELD
Practice Address - State:IL
Practice Address - Zip Code:62056-1780
Practice Address - Country:US
Practice Address - Phone:217-324-4233
Practice Address - Fax:217-324-8622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty