Active NPI 1578571386 Individual Practitioner Male Practitioner

Dr. Michael John Corcoran , MD

Orthopaedic Surgery • Bradley, IL

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Michael Corcoran, MD is a certified Orthopaedic Surgery practicing in Bradley, IL. With approximately 35 years of clinical experience since graduating from Southern College Of Medicine And Surgery in 1991, Dr. Corcoran delivers high-quality medical care to the local community at 400 SOUTH KENNEDY DR.

Dr. Corcoran is affiliated with Illinois Bone And Joint Institute, Llc and accepts Medicare assignment.

Frequently performed procedures and clinical services include injection, triamcinolone acetonide, not otherwise specified, 10 mg, established patient outpatient office visit, aspiration and/or injection of fluid from large joint. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

400 South Kennedy Dr

Bradley, IL 60915

Telephone 8159288050

Fax 8005052218

Associated Practice Facility / Clinic

🏢 Illinois Bone And Joint Institute, Llc Facility NPI 1184263055

Medicare Profile & Education

Medical School

Southern College Of Medicine And Surgery

Graduation Year

1991

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Orthopaedic Surgery in Bradley, IL

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

35 Yrs +3.2 yrs vs City Avg

City Avg: 31.8 Yrs

State Avg: 27.0 Yrs

Regional Practice Density

9 Specialists

Practicing in Bradley, IL (1064 Statewide)

Telehealth Adoption Rate

22.2% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

85.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Corcoran (35 Years) 35 Yrs

Bradley Specialty Average (31.8 Years) 31.8 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	1,619	283	$3.00	$0.97
99213 Established patient office or other outpatient visit, typically 15 minutes	695	427	$205.07	$86.31
20610 Aspiration and/or injection of fluid from large joint	546	345	$295.86	$68.45
73030 X-ray of shoulder, minimum of 2 views	201	175	$158.33	$34.69
J7326 Hyaluronan or derivative, gel-one, for intra-articular injection, per dose	180	124	$1260.73	$509.11
73564 X-ray of knee, 4 or more views	146	140	$193.15	$50.24
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	139	121	$285.66	$120.45
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	113	113	$255.00	$104.75
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	99	93	$125.00	$53.15
73562 X-ray of knee, 3 views	90	84	$139.24	$38.39
J7323 Hyaluronan or derivative, euflexxa, for intra-articular injection, per dose	67	27	$304.69	$119.91
27447 Replacement of knee joint, both sides of knee	51	50	$8564.00	$1249.42
73221 Mri scan of arm joint without contrast	45	45	$1378.00	$128.70
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	42	42	$377.00	$160.82
73721 Mri scan of leg joint without contrast	28	28	$1384.00	$129.83
23472 Prosthetic repair of shoulder joint, total shoulder	21	21	$10077.00	$1422.97
72110 X-ray of lower and sacral spine, minimum of 4 views	16	16	$180.94	$42.39
29827 Repair of shoulder rotator cuff using an endoscope	14	13	$6742.00	$1049.63
72050 X-ray of upper spine, 4 or 5 views	13	13	$195.38	$46.28
72148 MRI scan of lower spinal canal	12	12	$1507.00	$113.95
73080 X-ray of elbow, minimum of 3 views	12	12	$115.33	$27.54
29826 Shaving of part of shoulder bone and repair of ligament using an endoscope	11	11	$4864.00	$168.90
72141 MRI scan of upper spinal canal	11	11	$1471.00	$113.59

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	1,843	333	$3.00	$1.07
99213 Established patient office or other outpatient visit, typically 15 minutes	587	386	$205.09	$85.24
20610 Aspiration and/or injection of fluid from large joint	568	369	$282.22	$66.12
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	257	212	$285.00	$120.23
73030 X-ray of shoulder, minimum of 2 views	217	191	$143.53	$33.62
73564 X-ray of knee, 4 or more views	197	189	$181.30	$49.16
J7326 Hyaluronan or derivative, gel-one, for intra-articular injection, per dose	152	119	$1345.47	$510.23
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	95	95	$255.00	$108.33
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	85	85	$377.00	$161.03
73221 Mri scan of arm joint without contrast	78	78	$1258.61	$133.98
73562 X-ray of knee, 3 views	76	69	$136.05	$38.68
27447 Replacement of knee joint, both sides of knee	58	58	$8163.55	$1228.54
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	51	51	$125.00	$53.37
23472 Prosthetic repair of shoulder joint, total shoulder	30	30	$9556.60	$1394.83
73721 Mri scan of leg joint without contrast	24	24	$1308.29	$136.82
J7323 Hyaluronan or derivative, euflexxa, for intra-articular injection, per dose	24	12	$322.75	$85.77
29826 Shaving of part of shoulder bone and repair of ligament using an endoscope	19	19	$4500.42	$171.35
73502 X-ray of hip, 2-3 views	18	18	$160.78	$43.85
29827 Repair of shoulder rotator cuff using an endoscope	18	18	$6210.33	$1057.54
72110 X-ray of lower and sacral spine, minimum of 4 views	15	15	$207.40	$41.52
73080 X-ray of elbow, minimum of 3 views	15	14	$109.79	$27.87
72050 X-ray of upper spine, 4 or 5 views	15	15	$180.41	$45.47
72141 MRI scan of upper spinal canal	11	11	$1421.82	$117.03

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	1,340	244	$3.00	$1.14
20610 Aspiration and/or injection of fluid from large joint	370	266	$282.38	$67.70
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	280	226	$125.00	$54.34
99213 Established patient office or other outpatient visit, typically 15 minutes	261	202	$205.19	$85.98
73030 X-ray of shoulder, minimum of 2 views	238	206	$112.58	$29.70
73564 X-ray of knee, 4 or more views	206	179	$136.99	$41.05
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	114	106	$285.00	$124.02
73562 X-ray of knee, 3 views	93	80	$119.98	$36.93
J7326 Hyaluronan or derivative, gel-one, for intra-articular injection, per dose	81	62	$1569.00	$888.00
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	56	56	$377.00	$163.07
73221 Mri scan of arm joint without contrast	53	53	$1126.31	$137.71
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	52	51	$400.00	$175.16
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	45	45	$255.00	$109.37
27447 Replacement of knee joint, both sides of knee	41	39	$7458.00	$1284.87
29826 Shaving of part of shoulder bone and repair of ligament using an endoscope	28	28	$4236.00	$174.29
29827 Repair of shoulder rotator cuff using an endoscope	25	25	$5872.00	$1066.04
23472 Prosthetic repair of shoulder joint, total shoulder	20	19	$8776.00	$1447.31
73721 Mri scan of leg joint without contrast	19	19	$1113.62	$137.64
73610 X-ray of ankle, minimum of 3 views	18	15	$104.35	$30.95
73502 X-ray of hip, 2-3 views	18	18	$136.84	$41.01
73080 X-ray of elbow, minimum of 3 views	16	15	$93.21	$26.23
29823 Removal of extensive shoulder joint tissue using an endoscope	16	16	$4071.00	$300.05
72050 X-ray of upper spine, 4 or 5 views	15	15	$162.22	$45.40
72110 X-ray of lower and sacral spine, minimum of 4 views	13	13	$163.91	$43.91
73630 X-ray of foot, minimum of 3 views	13	11	$91.94	$25.31

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	1,260	234	$3.05	$1.26
20610 Aspiration and/or injection of fluid from large joint	342	245	$279.50	$66.59
99213 Established patient office or other outpatient visit, typically 15 minutes	255	201	$181.31	$87.83
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	252	199	$110.66	$53.26
73030 X-ray of shoulder, minimum of 2 views	214	177	$127.64	$30.96
73564 X-ray of knee, 4 or more views	202	164	$140.03	$40.31
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	188	158	$255.56	$126.51
73562 X-ray of knee, 3 views	69	63	$117.85	$33.16
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	62	62	$251.65	$109.10
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	52	52	$377.00	$165.13
73221 Mri scan of arm joint without contrast	51	49	$1320.52	$143.99
27447 Replacement of knee joint, both sides of knee	50	48	$7458.00	$1275.20
J7326 Hyaluronan or derivative, gel-one, for intra-articular injection, per dose	50	42	$1762.26	$1206.04
73560 X-ray of knee, 1-2 views	34	32	$106.39	$30.57
73502 X-ray of hip, 2-3 views	27	26	$141.65	$40.49
29823 Removal of extensive shoulder joint tissue using an endoscope	25	25	$4071.00	$218.49
29826 Shaving of part of shoulder bone and repair of ligament using an endoscope	24	24	$4236.00	$177.38
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	23	21	$400.00	$172.23
29827 Repair of shoulder rotator cuff using an endoscope	21	21	$5872.00	$1047.61
73721 Mri scan of leg joint without contrast	19	18	$1327.35	$134.23
73610 X-ray of ankle, minimum of 3 views	19	15	$110.04	$30.70
23472 Prosthetic repair of shoulder joint, total shoulder	15	15	$8776.00	$1465.86
72050 X-ray of upper spine, 4 or 5 views	15	15	$182.00	$46.47
99202 New patient office or other outpatient visit, typically 20 minutes	14	14	$168.00	$71.17
73630 X-ray of foot, minimum of 3 views	13	11	$108.29	$29.96
72110 X-ray of lower and sacral spine, minimum of 4 views	12	12	$189.98	$48.08
72148 MRI scan of lower spinal canal	12	12	$1420.58	$128.42

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	1,541	280	$3.48	$1.43
20610 Aspiration and/or injection of fluid from large joint	440	307	$286.22	$66.87
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	284	238	$237.75	$104.89
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	262	203	$98.14	$42.45
99213 Established patient office or other outpatient visit, typically 15 minutes	226	193	$163.53	$72.23
73030 X-ray of shoulder, minimum of 2 views	220	184	$94.69	$28.70
73564 X-ray of knee, 4 or more views	199	166	$126.94	$38.79
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	150	150	$243.96	$104.68
27447 Replacement of knee joint, both sides of knee	80	74	$6587.05	$1374.36
J7326 Hyaluronan or derivative, gel-one, for intra-articular injection, per dose	80	59	$1873.90	$1144.84
73562 X-ray of knee, 3 views	80	63	$113.00	$34.96
73221 Mri scan of arm joint without contrast	59	58	$1172.36	$144.99
73560 X-ray of knee, 1-2 views	50	47	$98.16	$29.13
29826 Shaving of part of shoulder bone and repair of ligament using an endoscope	35	35	$1800.11	$167.51
J7321 Hyaluronan or derivative, hyalgan, supartz or visco-3, for intra-articular injection, per dose	34	16	$212.00	$79.09
29823 Removal of extensive shoulder joint tissue using an endoscope	34	34	$2884.44	$201.22
29827 Repair of shoulder rotator cuff using an endoscope	31	31	$4811.61	$1006.97
73502 X-ray of hip, 2-3 views	26	25	$130.27	$40.62
23472 Prosthetic repair of shoulder joint, total shoulder	19	18	$6897.16	$1503.68
72110 X-ray of lower and sacral spine, minimum of 4 views	14	14	$156.50	$42.55
72050 X-ray of upper spine, 4 or 5 views	13	13	$142.00	$42.89
73610 X-ray of ankle, minimum of 3 views	13	12	$99.77	$28.59
73080 X-ray of elbow, minimum of 3 views	12	11	$98.75	$26.70
73630 X-ray of foot, minimum of 3 views	12	11	$94.50	$23.73
73721 Mri scan of leg joint without contrast	11	11	$1177.09	$150.95

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	2,392	397	$5.00	$1.56
20610 Aspiration and/or injection of fluid from large joint	897	425	$272.31	$63.81
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	458	312	$94.00	$43.09
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	342	291	$229.00	$104.36
J7321 Hyaluronan or derivative, hyalgan, supartz or visco-3, for intra-articular injection, per dose	326	101	$300.00	$78.30
73030 X-ray of shoulder, minimum of 2 views	322	248	$119.00	$27.66
99213 Established patient office or other outpatient visit, typically 15 minutes	272	216	$156.00	$70.46
73564 X-ray of knee, 4 or more views	267	210	$134.00	$38.37
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	229	229	$235.00	$106.45
73562 X-ray of knee, 3 views	81	69	$113.00	$34.13
J7326 Hyaluronan or derivative, gel-one, for intra-articular injection, per dose	73	55	$2160.00	$1144.43
27447 Replacement of knee joint, both sides of knee	70	68	$6987.43	$1349.40
73221 Mri scan of arm joint without contrast	64	62	$1343.88	$154.85
73560 X-ray of knee, 1-2 views	56	51	$99.00	$28.80
73502 X-ray of hip, 2-3 views	39	36	$131.00	$39.88
73721 Mri scan of leg joint without contrast	28	26	$1335.14	$152.41
23472 Prosthetic repair of shoulder joint, total shoulder	27	27	$8106.00	$1434.55
29826 Shaving of part of shoulder bone and repair of ligament using an endoscope	26	25	$3692.00	$170.14
72110 X-ray of lower and sacral spine, minimum of 4 views	23	23	$176.00	$45.73
29827 Repair of shoulder rotator cuff using an endoscope	22	22	$5361.00	$991.15
73610 X-ray of ankle, minimum of 3 views	17	14	$109.00	$27.25
73080 X-ray of elbow, minimum of 3 views	15	11	$107.00	$27.47
73630 X-ray of foot, minimum of 3 views	14	12	$102.00	$24.83

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J7328 Hyaluronan or derivative, gelsyn-3, for intra-articular injection, 0.1 mg	26,712	50	$4.00	$2.14
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	1,866	345	$5.00	$1.76
20610 Aspiration and/or injection of fluid from large joint	837	389	$276.32	$64.32
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	367	270	$94.00	$42.10
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	364	295	$229.00	$104.29
J7321 Hyaluronan or derivative, hyalgan, supartz or visco-3, for intra-articular injection, per dose	293	92	$300.00	$83.51
73030 X-ray of shoulder, minimum of 2 views	257	209	$119.00	$26.69
73564 X-ray of knee, 4 or more views	253	204	$134.00	$36.09
99213 Established patient office or other outpatient visit, typically 15 minutes	237	197	$156.00	$70.27
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	160	160	$235.00	$104.82
27447 Replacement of knee joint, both sides of knee	77	72	$6889.00	$1328.23
73560 X-ray of knee, 1-2 views	58	57	$99.00	$28.50
73221 Mri scan of arm joint without contrast	57	57	$1291.00	$155.89
29826 Shaving of part of shoulder bone and repair of ligament using an endoscope	50	50	$3692.00	$176.65
73562 X-ray of knee, 3 views	49	44	$113.00	$33.05
99202 New patient office or other outpatient visit, typically 20 minutes	43	43	$161.00	$72.97
29827 Repair of shoulder rotator cuff using an endoscope	35	35	$5361.00	$1028.95
73502 X-ray of hip, 2-3 views	33	33	$131.00	$37.95
73721 Mri scan of leg joint without contrast	28	27	$1276.00	$155.65
72110 X-ray of lower and sacral spine, minimum of 4 views	21	20	$176.00	$41.92
72050 X-ray of upper spine, 4 or 5 views	16	15	$173.00	$39.91
23472 Prosthetic repair of shoulder joint, total shoulder	15	15	$8106.00	$1474.31
73610 X-ray of ankle, minimum of 3 views	13	13	$109.00	$25.69
20605 Aspiration and/or injection of medium joint or joint capsule	12	11	$194.00	$49.65
73080 X-ray of elbow, minimum of 3 views	11	11	$107.00	$28.08

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J7328 Hyaluronan or derivative, gelsyn-3, for intra-articular injection, 0.1 mg	37,128	80	$4.00	$2.14
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	1,824	317	$5.00	$1.77
20610 Aspiration and/or injection of fluid from large joint	727	359	$282.42	$65.04
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	350	272	$94.00	$41.23
73564 X-ray of knee, 4 or more views	303	237	$134.00	$35.26
99213 Established patient office or other outpatient visit, typically 15 minutes	286	244	$156.00	$70.26
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	256	232	$229.00	$102.64
73030 X-ray of shoulder, minimum of 2 views	193	169	$119.00	$26.14
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	148	148	$235.00	$104.07
J7321 Hyaluronan or derivative, hyalgan, supartz or visco-3, for intra-articular injection, per dose	117	42	$300.00	$85.09
73562 X-ray of knee, 3 views	94	76	$113.00	$31.41
27447 Replacement of knee joint, both sides of knee	76	73	$7070.32	$1348.79
73560 X-ray of knee, 1-2 views	75	72	$99.00	$26.48
73221 Mri scan of arm joint without contrast	56	55	$1291.00	$165.22
J7323 Hyaluronan or derivative, euflexxa, for intra-articular injection, per dose	44	14	$300.00	$152.38
29826 Shaving of part of shoulder bone and repair of ligament using an endoscope	42	42	$3735.95	$176.04
29827 Repair of shoulder rotator cuff using an endoscope	31	31	$5447.48	$1059.29
73721 Mri scan of leg joint without contrast	29	26	$1276.00	$151.06
77080 Dxa bone density measurement of hip, pelvis, spine	29	29	$288.00	$28.77
99202 New patient office or other outpatient visit, typically 20 minutes	24	24	$161.00	$68.39
73502 X-ray of hip, 2-3 views	17	17	$131.00	$38.23
23472 Prosthetic repair of shoulder joint, total shoulder	16	16	$8106.00	$1469.68
72050 X-ray of upper spine, 4 or 5 views	11	11	$173.00	$41.64

Medical Specialties & State Licenses

Orthopaedic Surgery Primary Specialty

NUCC Taxonomy Code: 207X00000X

State License IL 036-95825

An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

036-95825 (IL)

Hospital & Practice Group Affiliations

Illinois Bone And Joint Institute, Llc

500 W Court St, Kankakee, IL 609013661

Phone: 8159372400

Illinois Bone And Joint Institute, Llc

2401 Ravine Way, Glenview, IL 600257645

Illinois Bone And Joint Institute, Llc

350 N Wall St, Kankakee, IL 609012901

Phone: 8159331671

Illinois Bone And Joint Institute, Llc

2101 Waukegan Rd, Bannockburn, IL 600151836

Illinois Bone And Joint Institute, Llc

6712 N Convent St, Bourbonnais, IL 609141528

Phone: 8159288050

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

31 Associated Practitioners

Dr. William Mosenthal , MD

Orthopaedic Surgery

NPI 1023499480

Doctor of Medicine (M.D.)

Dr. Vishal Desai , MD

Orthopaedic Surgery

NPI 1073074027

Doctor of Medicine (M.D.)

Kristin Fields , PA-C

Physician Assistant - Surgical

NPI 1184714198

Physician Assistant (Certified)

Tiffany Hartman

Nurse Practitioner

NPI 1194608927

Austin Chinn

Podiatrist

NPI 1225599236

Molly Hartig

Physician Assistant

NPI 1265934897

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events

✅

NPI Profile Active April 06, 2016

NPI status registered as active in NPPES database

📍

Updated Practice Location April 06, 2016

Registered at 400 SOUTH KENNEDY DR, BRADLEY, IL 60915 (Tel: 8159288050)

📍

Updated Business Mailing Address April 06, 2016

Registered at 400 SOUTH KENNEDY DR, BRADLEY, IL 60915 (Tel: 8159288050)

👤

Provider Name / Credentials Updated April 06, 2016

Recorded as MICHAEL CORCORAN, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) April 06, 2016

Orthopaedic Surgery (License #036-95825 in IL)

🟢

Initial NPI Registration & Enumeration August 04, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1578571386

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: August 04, 2006

Last Update: April 06, 2016

Sole Proprietor: No

Update or Correct Profile

Mailing Address

400 South Kennedy Dr

Bradley, IL 60915

Phone: 8159288050

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

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