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Orthopedic & Shoulder Center, S.C.

Orthopaedic Surgery in Normal, IL. Organization (NPI-2).

NPI number1437453073
StatusActive
Last updated in NPPESApr 21, 2015

Details

NPI
1437453073
Entity type
Organization (NPI-2)
Legal business name
Orthopedic & Shoulder Center, S.C.
Organization subpart
No
Enumeration date
Dec 22, 2010
Last updated
Apr 21, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207X00000X Orthopaedic Surgery036092458ILYes

Practice location

2200 Fort Jesse Rd Ste 250
Normal, IL 61761-6290

Phone 309-454-1616 · Fax 309-454-5167

Mailing address

2200 Fort Jesse Road
Suite 250
Normal, IL 61761

Phone 309-888-9800 · Fax 309-828-9700

Authorized official

Brandi Meisner
Administrator
3098889800

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