Provider Demographics
NPI:1205313566
Name:MIDWEST ORTHOPEDIC NETWORK KANSAS
Entity type:Organization
Organization Name:MIDWEST ORTHOPEDIC NETWORK KANSAS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ROSEMARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ISAILY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-951-8200
Mailing Address - Street 1:710 N DEARBORN ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60654-5900
Mailing Address - Country:US
Mailing Address - Phone:312-951-8200
Mailing Address - Fax:312-981-1293
Practice Address - Street 1:6500 W 143RD STREET
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66223
Practice Address - Country:US
Practice Address - Phone:312-951-8200
Practice Address - Fax:312-981-1293
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-19
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports MedicineGroup - Multi-Specialty