Competitive Edge Sports Medicine in Breese - Sports Medicine
Competitive Edge Sports Medicine - NPI 1104000561
Competitive Edge Sports Medicine is a Sports Medicine in Breese, Illinois. Competitive Edge Sports Medicine practices all healthcare services and medical treatments related to Sports Medicine. The NPI Number for Competitive Edge Sports Medicine is 1104000561. The last update date is 2007-12-20.
Competitive Edge Sports Medicine's current location address is 9431 Holy Cross Ln, Breese, Illinois. You can contact this provider via phone number 6185262603 and fax number 6185261435. The mailing address for Competitive Edge Sports Medicine is 9431 Holy Cross Ln, Breese, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Competitive Edge Sports Medicine |
|---|---|
| Address | 9431 Holy Cross Ln, Breese, Illinois |
| Phone Number | 6185262603 |
| Fax Number | 6185261435 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT |
|---|---|
| Authorized Official Name | Neighbors L David |
| Credentials | MD |
| Telephone Number | 6185262603 |
NPI Number Detail
| NPI Number | 1104000561 |
|---|---|
| Provider Enumeration Date | 2007-12-20 |
| Last Updated Date | 2007-12-20 |
Provider Mailing Address Detail
| Address | 9431 Holy Cross Ln |
|---|---|
| City | Breese |
| State | Illinois (IL) |
| Post Code | 622303510 |
| Phone Number | 6185262603 |
| Fax Number | 6185261435 |
Provider's Primary Taxonomy Detail
| Speciality | Sports Medicine |
|---|---|
| Taxonomy | 207Qs0010X |
|
Definition: A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1400053 | IL | BCBS |
Post Comment/ Review Below
What is the Competitive Edge Sports Medicine's 1104000561?
The Competitive Edge Sports Medicine's NPI (National Provider Identifier) Number is 1104000561. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical location address where Competitive Edge Sports Medicine's facilities are situated?
The facilities of Competitive Edge Sports Medicine are physically located at the following address: 9431 Holy Cross Ln, Breese, IL, 622303510.
What is Competitive Edge Sports Medicine's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Competitive Edge Sports Medicine is Sports Medicine, and the taxonomy code that categorizes this field of expertise is 207Qs0010X.
On what date did the Competitive Edge Sports Medicine receive its 1104000561 assignment from the Centers for Medicare & Medicaid Services?
The Competitive Edge Sports Medicine was assigned its 1104000561 by the Centers for Medicare & Medicaid Services on 2007-12-20.
As of what date were the details related to Competitive Edge Sports Medicine most recently updated or revised?
The information pertaining to Competitive Edge Sports Medicine, including its address, specialty, and other relevant details, was last updated or revised on 2007-12-20.