Provider Demographics
NPI:1801844642
Name:OAD ORTHOPAEDICS, LTD
Entity type:Organization
Organization Name:OAD ORTHOPAEDICS, LTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:KRAUKLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-225-2663
Mailing Address - Street 1:27650 FERRY RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WARRENVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60555-3845
Mailing Address - Country:US
Mailing Address - Phone:630-225-2663
Mailing Address - Fax:630-225-2399
Practice Address - Street 1:27650 FERRY RD
Practice Address - Street 2:SUITE 100
Practice Address - City:WARRENVILLE
Practice Address - State:IL
Practice Address - Zip Code:60555-3845
Practice Address - Country:US
Practice Address - Phone:630-225-2663
Practice Address - Fax:630-225-2399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-04
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL206229OtherMEDICARE GRP #
IL02201368OtherBCBS PROVIDER #
IL204398OtherMEDICARE GROUP #
IL206224OtherMEDICARE GROUP #
IL206229OtherMEDICARE GRP #
IL206224OtherMEDICARE GROUP #