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Contact Information

DECATUR ORTHOPEDIC CENTER, LLC
104 ASHLAND AVE.
MOUNT ZION, IL62549
 Phone: 217-864-2665
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Orthopaedic Surgery

207X00000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for DECATUR ORTHOPEDIC CENTER, LLC

NPI # 1336586114
LBN Legal business name DECATUR ORTHOPEDIC CENTER, LLC
Authorized official JACOB SAMS - (CHIEF MANAGING MEMBER)
Entity Organization
Organization subpart 1 No
Enumeration date 06/03/2013
Last updated 02/23/2022 - About 4 years ago
Identifiers
IL License # 125-052745
IL Other 1154511517 INDIVIDUAL NPI
IL Other 1730340498 INDIVIDUAL NPI
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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