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LINCOLN TRAIL ORTHOPAEDIC CLINIC S.C. NPI 1366615668


NPI Information

NPI: 1366615668
Provider Name: LINCOLN TRAIL ORTHOPAEDIC CLINIC, S.C.
Classification: Orthopaedic Surgery - 207X00000X
Entity Type: Organization
Address:
103 PROFESSIONAL PLZ
MATTOON, IL
ZIP 61938
Phone: (217) 348-1030
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LINCOLN TRAIL ORTHOPAEDIC CLINIC, S.C. is an orthopaedic surgery in Mattoon, IL. The provider is 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. LINCOLN TRAIL ORTHOPAEDIC CLINIC, S.C. NPI is 1366615668. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

103 PROFESSIONAL PLZ
MATTOON, IL
ZIP 61938-252
Phone: (217) 348-1030
Fax: (217) 348-1090

The provider's authorized official is Julee Lee .
The authorized official title is Office Manager and has the following contact phone number (217) 348-1052.

The enumeration date for this NPI number is 4/8/2008 and was last updated on 4/8/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207X00000XOrthopaedic Surgery036058473ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11515701OTHERILLINOISBLUE CROSS BLUE SHIELD
2C40943MEDICARE UPINILLINOIS
3133038OTHERILLINOISHEALTHLINK
4236090MEDICARE PINILLINOIS
5002811OTHERILLINOISHEALTH ALLIANCE
6036058473MEDICAIDILLINOIS
7791203439OTHERILLINOISRAILROAD MEDICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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