MEDICARE: CHICAGO SPINE AND JOINT, S.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207LP2900X	Pain Medicine (Anesthesiology) Physician

General Provider Information

NPI Number	:	1407713613
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHICAGO SPINE AND JOINT, S.C.

Provider Business Mailing Address
First Line	:	907 N ELM ST STE 101
Second Line	:
City	:	HINSDALE
State	:	IL
Zip	:	60521-3644
Country	:	US
Telephone Number	:	708-485-4200
Fax Number	:

Provider Business Practice Location Address
First Line	:	1129 W 159TH ST
Second Line	:
City	:	ORLAND PARK
State	:	IL
Zip	:	60467
Country	:	US
Telephone Number	:	708-482-4500
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	ALEXIS GOEDERT
Credential	:
Telephone Number	:	773-416-1013

Provider Enumeration Date	:	01/08/2026
Last Update Date	:	05/20/2026

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Directions to “CHICAGO SPINE AND JOINT, S.C. ” Practice Location

Language	Start Address	Practice Location

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