Provider Demographics
NPI:1245100932
Name:ORTHOMIDWEST, PLLC
Entity type:Organization
Organization Name:ORTHOMIDWEST, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPLE PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:BEAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:815-398-9491
Mailing Address - Street 1:PO BOX 735263
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60673-5263
Mailing Address - Country:US
Mailing Address - Phone:847-285-4200
Mailing Address - Fax:
Practice Address - Street 1:120 E HIGGINS RD
Practice Address - Street 2:
Practice Address - City:ELK GROVE VILLAGE
Practice Address - State:IL
Practice Address - Zip Code:60007-1434
Practice Address - Country:US
Practice Address - Phone:847-285-4200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-07
Last Update Date:2025-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies