Provider Demographics
NPI:1699892794
Name:ORTHOPEDIC ASSOCIATES OF NAPERVILLE SC
Entity type:Organization
Organization Name:ORTHOPEDIC ASSOCIATES OF NAPERVILLE SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:G
Authorized Official - Last Name:MARKARIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-355-3774
Mailing Address - Street 1:10 W MARTIN AVE
Mailing Address - Street 2:SUITE 50
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-6535
Mailing Address - Country:US
Mailing Address - Phone:630-355-3774
Mailing Address - Fax:630-355-3776
Practice Address - Street 1:10 W MARTIN AVE
Practice Address - Street 2:SUITE 50
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-6535
Practice Address - Country:US
Practice Address - Phone:630-355-3774
Practice Address - Fax:630-355-4953
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2009-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0166170001Medicare NSC