Provider Demographics
NPI:1184769911
Name:ORTHOPEDIC ASSOCIATES, SC
Entity type:Organization
Organization Name:ORTHOPEDIC ASSOCIATES, SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:Y
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-593-5511
Mailing Address - Street 1:415 W GOLF RD
Mailing Address - Street 2:SUITE 68
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-3929
Mailing Address - Country:US
Mailing Address - Phone:847-593-5511
Mailing Address - Fax:847-593-0872
Practice Address - Street 1:415 W GOLF RD
Practice Address - Street 2:SUITE 68
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-3929
Practice Address - Country:US
Practice Address - Phone:847-593-5511
Practice Address - Fax:847-593-0872
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL042-000037174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1615125OtherGROUP BCBS #
IL0607120001OtherCIGNA GROUP #
IL767190Medicare ID - Type UnspecifiedGROUP NUMBER
ILCF4186Medicare ID - Type UnspecifiedRAILROAD MEDICARE GROUP #