Provider Demographics
NPI:1467750448
Name:HINSDALE ORTHOPAEDIC ASSOCIATES,SC
Entity Type:Organization
Organization Name:HINSDALE ORTHOPAEDIC ASSOCIATES,SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:DURKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-794-8671
Mailing Address - Street 1:1 ERIE CT
Mailing Address - Street 2:SUITE 7120
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-2566
Mailing Address - Country:US
Mailing Address - Phone:708-848-4662
Mailing Address - Fax:708-848-7113
Practice Address - Street 1:1 ERIE CT
Practice Address - Street 2:SUITE 7120
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60302-2566
Practice Address - Country:US
Practice Address - Phone:708-848-4662
Practice Address - Fax:708-848-7113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-01
Last Update Date:2017-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL042000346174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL700860Medicare PIN