Provider Demographics
NPI:1275826984
Name:G&U ORTHOPEDIC, LLC
Entity Type:Organization
Organization Name:G&U ORTHOPEDIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GUSTAVO
Authorized Official - Middle Name:
Authorized Official - Last Name:URBINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-643-0241
Mailing Address - Street 1:106 W. CALENDAR AVE.
Mailing Address - Street 2:127
Mailing Address - City:LA GRANGE
Mailing Address - State:IL
Mailing Address - Zip Code:60525
Mailing Address - Country:US
Mailing Address - Phone:312-643-0241
Mailing Address - Fax:312-643-0691
Practice Address - Street 1:106 W. CALENDAR AVE.
Practice Address - Street 2:127
Practice Address - City:LA GRANGE
Practice Address - State:IL
Practice Address - Zip Code:60525
Practice Address - Country:US
Practice Address - Phone:312-643-0241
Practice Address - Fax:312-643-0691
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-27
Last Update Date:2011-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL203001193332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies