ORTHOPAEDIC SURGERY CENTER OF ILLINOIS, LLC


Address: 3136 Old Jacksonville Rd, Suite 250, Springfield, IL 62704-6487
Phone: 2178620500

ORTHOPAEDIC SURGERY CENTER OF ILLINOIS, LLC (NPI# 1760457204) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1760457204
Entity Type Organization
Organization Name ORTHOPAEDIC SURGERY CENTER OF ILLINOIS, LLC
Practice Address 3136 Old Jacksonville Rd
Suite 250
Springfield
IL 62704-6487
Practice Telephone 2178620500
Mailing Telephone 2178620500
Enumeration Date 2006-02-20
Last Update Date 2010-01-11
Authorized Official Name KIM SCHULTZ (DIRECTOR)
Authorized Official Telephone 2178620500
Authorized Official Credential RN
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QA1903X Clinic/Center
Specialization: Ambulatory Surgical
7002306 IL Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
IL 007002306 05
IL RR MEDICARE 490004938 01

Office Location

Street Address 3136 OLD JACKSONVILLE RD
SUITE 250
City SPRINGFIELD
State IL
Zip Code 62704-6487

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Taxonomy Information

Taxonomy Code 261QA1903X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Ambulatory Surgical

Taxonomy Definition

Definition to come...

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1205810553 Orthopaedic Asc of Springfield LLC Clinic/Center 3045 S National Ave, Suite 101, Springfield, MO 65804-4247 2005-11-30
1578551594 Mercy Surgery Center, Ltd Clinic/Center 2610 N Limestone St, Springfield, OH 45503-1114 2005-10-13
1366449910 Oregon Endoscopy Center, LLC Clinic/Center 3355 Riverbend Dr, Suite 510, Springfield, OR 97477-8800 2005-06-28
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1295738375 Oregon Surgicenter LLC Clinic/Center 2400 Hartman Ln, Ste 300, Springfield, OR 97477-1198 2005-05-23
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Competitor

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City SPRINGFIELD
Zip Code 62704

Improve Information

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Dataset Information

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.

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