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NPI Code Detail

MEDICARE: SPINE CENTERS INSTITUTE, INC.

MEDICARE: SPINE CENTERS INSTITUTE, INC.
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
1261QA1903XAmbulatory Surgical Clinic/Center1473456IL

General Provider Information

NPI Number : 1437275815
Entity Type Code : Organization
Provider Name (Legal Business Name) : SPINE CENTERS INSTITUTE, INC.
Provider Business Mailing Address
First Line : 5252 N WESTERN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60625-2448
Country : US
Telephone Number : 773-878-7909
Fax Number : 773-878-2311
Provider Business Practice Location Address
First Line : 601 W RANDOLPH ST
Second Line :
City : CHICAGO
State : IL
Zip : 60661-2232
Country : US
Telephone Number : 773-878-7909
Fax Number : 773-878-2311
Authorized Official
Title or Position : BUSINESS ADMINISTRATOR
Name : MARC STRONGIN
Credential : D.C.
Telephone Number : 773-878-7909
Provider Enumeration Date : 03/21/2007
Last Update Date : 08/22/2020

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Directions to “SPINE CENTERS INSTITUTE, INC. ” Practice Location

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