Provider Demographics
NPI:1265710495
Name:COMBINED ORTHOPAEDIC SPECIALISTS
Entity type:Organization
Organization Name:COMBINED ORTHOPAEDIC SPECIALISTS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:FRANS
Authorized Official - Last Name:HOEKSEMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-928-8701
Mailing Address - Street 1:7600 W COLLEGE DR
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:PALOS HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60463-1001
Mailing Address - Country:US
Mailing Address - Phone:630-928-8701
Mailing Address - Fax:630-928-8709
Practice Address - Street 1:7600 W COLLEGE DR
Practice Address - Street 2:2ND FLOOR
Practice Address - City:PALOS HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60463-1001
Practice Address - Country:US
Practice Address - Phone:630-928-8701
Practice Address - Fax:630-928-8709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-21
Last Update Date:2011-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty