Provider Demographics
NPI:1457535452
Name:ASSOCIATES IN ORTHOPAEDIC SURGERY
Entity Type:Organization
Organization Name:ASSOCIATES IN ORTHOPAEDIC SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CONSTANCE
Authorized Official - Middle Name:
Authorized Official - Last Name:DONNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-888-0750
Mailing Address - Street 1:1710 N RANDALL RD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-9400
Mailing Address - Country:US
Mailing Address - Phone:847-888-0750
Mailing Address - Fax:847-888-2152
Practice Address - Street 1:630 N RT 31
Practice Address - Street 2:SUITE 103
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60012
Practice Address - Country:US
Practice Address - Phone:815-455-0555
Practice Address - Fax:815-459-4204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-27
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy