ILLINOIS BONE AND JOINT INSTITUTE, LLC (NPI# 1669004610) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669004610 |
| Entity Type | Organization |
| Organization Name | ILLINOIS BONE AND JOINT INSTITUTE, LLC |
| Practice Address |
400 S Kennedy Dr Ste 100 Bradley IL 60915-2685 |
| Mailing Address |
900 Rand Rd Ste 300 Des Plaines IL 60016-2359 |
| Practice Telephone | 8159288050 |
| Practice Fax Number | 8159288932 |
| Mailing Telephone | 8473243976 |
| Mailing Fax Number | 8479291154 |
| Enumeration Date | 2020-02-07 |
| Last Update Date | 2020-02-07 |
| Authorized Official Name | WAYNE GOLDSTEIN (PRESIDENT) |
| Authorized Official Telephone | 8473243976 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 225X00000X | Occupational Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| N | 225100000X | Physical Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| Y | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265063648 | Illinois Bone and Joint Institute, LLC | Physical Therapist | 19552 S Harlem Ave Bldg D, Frankfort, IL 60423-6733 | 2020-02-04 |
| 1700417185 | Illinois Bone and Joint Institute, LLC | Orthopaedic Surgery | 1890 Silver Cross Blvd # A, New Lenox, IL 60451-9524 | 2020-02-04 |
| 1588207799 | Illinois Bone and Joint Institute, LLC | Orthopaedic Surgery | 2719 W Algonquin Rd, Algonquin, IL 60102-9400 | 2019-10-21 |
| 1669020848 | Illinois Bone and Joint Institute, LLC | Orthopaedic Surgery | 406 Front St Ste 100, Mchenry, IL 60050-5593 | 2019-08-30 |
| 1487202669 | Illinois Bone and Joint Institute, LLC | Physical Therapist | 406 Front St Ste 110, Mchenry, IL 60050-5593 | 2019-08-30 |
| 1457698243 | Illinois Bone and Joint Institute, LLC | Radiologic Technologist | 521 Green Bay Rd, Suite 100, Wilmette, IL 60091-2726 | 2013-01-14 |
| 1003153891 | Illinois Bone and Joint Institute, LLC | Radiologic Technologist | 350 S Greenleaf St Ste 401, Gurnee, IL 60031-5709 | 2013-01-14 |
| 1275692543 | Illinois Bone and Joint Institute, LLC | Orthopaedic Surgery | 101 Waukegan Rd Ste 990, Lake Bluff, IL 60044-1687 | 2006-12-06 |
| 1235298571 | Illinois Bone and Joint Institute, LLC | Occupational Therapist | 2101 Waukegan Rd Ste 108, Bannockburn, IL 60015-1836 | 2006-12-06 |
| 1447318878 | Illinois Bone and Joint Institute, LLC | Occupational Therapist | 724 Florsheim Dr, Libertyville, IL 60048-3757 | 2006-12-05 |
| Street Address |
400 S KENNEDY DR STE 100 |
| City | BRADLEY |
| State | IL |
| Zip Code | 60915-2685 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982886628 | Kimberly Ann Beaupre | Occupational Therapist | 400 S Kennedy Dr Ste 100, Bradley, IL 60915-2685 | 2007-12-05 |
| 1184263055 | Illinois Bone and Joint Institute, LLC | Orthopaedic Surgery | 400 S Kennedy Dr Ste 100, Bradley, IL 60915-2685 | 2019-12-24 |
| 1477196533 | Samantha M Corey | Physician Assistant | 400 S Kennedy Dr Ste 100, Bradley, IL 60915-2685 | 2019-10-22 |
| 1366092876 | Margaret Curtin | Physician Assistant | 400 S Kennedy Dr Ste 100, Bradley, IL 60915-2685 | 2019-09-17 |
| 1659809440 | Taylor R Atkinson | Physician Assistant | 400 S Kennedy Dr Ste 100, Bradley, IL 60915-2685 | 2017-05-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285232991 | Healthy Medical Inc | Family Medicine | 535 N. East St., Suite A, Bradley, IL 60915 | 2020-10-14 |
| 1679826309 | Heather Sevier | Specialist/Technologist | 328 S Dearborn Ave, Bradley, IL 60915 | 2012-10-18 |
| 1013266584 | Arlene De Leon Delacruz | Physical Therapist | 400 South Kennedy Dr., Bradley, IL 60915 | 2012-08-30 |
| 1023370699 | Jessica Sorensen | Physician Assistant | 350 N Kinzie Ave, Bradley, IL 60915 | 2012-06-11 |
| 1184993164 | Debra Malone | Behavioral Analyst | 136-142 1/2 South Clinton, Bradley, IL 60915 | 2011-12-21 |
| 1376840421 | Joshua R Johnson | Physician Assistant | 400 S. Kennedy, Bradley, IL 60915 | 2011-02-24 |
| 1801192133 | Eloise Adams | Behavioral Analyst | 136 142 1/2 South Clinton, Bradley, IL 60915 | 2011-02-03 |
| 1386948685 | Rico J Hale | Behavioral Analyst | 136 142 South Clinton, Bradley, IL 60915 | 2010-12-29 |
| 1558665851 | Joyce A Bollhorst | Behavioral Analyst | 136-142 South Clinton, Bradley, IL 60915 | 2010-12-29 |
| 1538469655 | Kankakee Valley Chiropractic | Chiropractor | 300 North Kennedy Drive, Suite 2, Bradley, IL 60915 | 2010-10-22 |
| Find all providers in zip 60915 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487662128 | Kermit S Muhammad | Orthopaedic Surgery | 400 South Kennedy, Bradley, IL 60915 | 2006-08-04 |
| 1578571386 | Michael John Corcoran | Orthopaedic Surgery | 400 South Kennedy Dr, Bradley, IL 60915 | 2006-08-04 |
| 1184263055 | Illinois Bone and Joint Institute, LLC | Orthopaedic Surgery | 400 S Kennedy Dr Ste 100, Bradley, IL 60915-2685 | 2019-12-24 |
| 1881851210 | Tomasz Taduesz Antkowiak | Orthopaedic Surgery | 400 S Kennedy Dr, Suite 100, Bradley, IL 60915 | 2008-05-22 |
| 1720191091 | Orthopedic Associates of Kankakee Sc | Orthopaedic Surgery | 400 S Kennedy Dr, Suite 100, Bradley, IL 60915-2685 | 2006-08-17 |
| 1447268289 | Eddie Jones | Orthopaedic Surgery | 400 South Kennedy Dr, Bradley, IL 60915 | 2006-08-04 |
| 1659389450 | Wesley Eugene Choy | Orthopaedic Surgery | 400 S Kennedy Dr, Bradley, IL 60915-2682 | 2006-08-04 |
| 1316955149 | Rajeev Damian Puri | Orthopaedic Surgery | 400 South Kennedy Dr, Bradley, IL 60915 | 2006-08-04 |
| 1891703609 | Alexander Eugene Michalow | Orthopaedic Surgery | 400 S Kennedy Dr, Bradley, IL 60915-2682 | 2006-08-04 |
| 1750399390 | Milton John Smit | Orthopaedic Surgery | 400 S Kennedy Dr, Bradley, IL 60915 | 2006-08-03 |
| Find all providers in BRADLEY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.