Provider Demographics
NPI:1669674693
Name:CENTER FOR ORTHOPAEDICS, P.C.
Entity Type:Organization
Organization Name:CENTER FOR ORTHOPAEDICS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:JAVORS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:219-865-3004
Mailing Address - Street 1:2001 US HIGHWAY 41 STE G
Mailing Address - Street 2:
Mailing Address - City:SCHERERVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46375-2827
Mailing Address - Country:US
Mailing Address - Phone:219-865-3004
Mailing Address - Fax:219-865-5000
Practice Address - Street 1:2001 US HIGHWAY 41 STE G
Practice Address - Street 2:
Practice Address - City:SCHERERVILLE
Practice Address - State:IN
Practice Address - Zip Code:46375-2827
Practice Address - Country:US
Practice Address - Phone:219-865-3004
Practice Address - Fax:219-865-5000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-01
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02001033A207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
90001255OtherBC/BS OF IL
IND94922Medicare UPIN
INDE3379Medicare PIN
IN233670Medicare PIN
90001255OtherBC/BS OF IL