Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Lindenwood University-Belleville

Organization Sports Medicine (Orthopaedic Surgery) Physician · NPI 1316499155

Lindenwood University-Belleville is a Sports Medicine (Orthopaedic Surgery) Physician in Belleville, Illinois. Licensed in Illinois. Registered with an NPI since 2016.

Licensed in
IL
In the registry since
2016

Practice location Address checks out

2600 W Main St
Belleville, IL 62226-6651
Phone: (972) 367-4845
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Sports Medicine (Orthopaedic Surgery) Physician (primary) Taxonomy 207XX0005X · Licence 036129925 (IL)

Record details

NPI number1316499155
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mouzon Bass — Agent · (972) 367-4845
Other names Lindenwood University-Belleville Sports Medicine
NPI enumeratedOctober 27, 2016
Last updated in NPPESOctober 27, 2016
Mailing address5050 Spring Valley Rd., Dallas, TX 75244-3909