Provider Demographics
NPI:1164621645
Name:ORLAND PARK ORTHOPEDICS
Entity Type:Organization
Organization Name:ORLAND PARK ORTHOPEDICS
Other - Org Name:ORLAND PARK ORTHOPEDICS CENTER FOR SPORTS MEDICINE
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRENT
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:RHODE
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:708-337-7704
Mailing Address - Street 1:700 W VAN BUREN ST STE C1
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60607-3617
Mailing Address - Country:US
Mailing Address - Phone:708-722-2555
Mailing Address - Fax:708-364-8443
Practice Address - Street 1:700 W VAN BUREN ST STE C1
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-3617
Practice Address - Country:US
Practice Address - Phone:708-722-2555
Practice Address - Fax:708-364-8443
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ORLAND PARK ORTHOPEDICS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-07-13
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty