| NPI | 1487654190 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE J GOLDBERG Owner 630-480-0490 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2005-07-22 |
| Last Update Date | 2017-01-25 |