Provider Demographics
NPI:1699835868
Name:ILLINOIS ORTHOPAEDIC AND HAND CENTER S C
Entity Type:Organization
Organization Name:ILLINOIS ORTHOPAEDIC AND HAND CENTER S C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TOM
Authorized Official - Middle Name:A
Authorized Official - Last Name:KARNEZIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-439-1200
Mailing Address - Street 1:8901 GOLF RD STE 203
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-4028
Mailing Address - Country:US
Mailing Address - Phone:847-439-1200
Mailing Address - Fax:847-439-1212
Practice Address - Street 1:8901 GOLF RD STE 203
Practice Address - Street 2:
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-4028
Practice Address - Country:US
Practice Address - Phone:847-439-1200
Practice Address - Fax:847-439-1212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036085306207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036085306Medicaid
1633094OtherBCBS
P00012437OtherRRMC
IL036085306Medicaid
P00012437OtherRRMC