Healthcare Provider Details

I. General information

NPI: 1891401667
Provider Name (Legal Business Name): METRO CHICAGO SPINE & PAIN CONSULTANTS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2023
Last Update Date: 03/14/2025
Certification Date: 03/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5645 W ADDISON ST FL 2
CHICAGO IL
60634-4403
US

IV. Provider business mailing address

1511 N CONVENT ST STE 700-281
BOURBONNAIS IL
60914-1470
US

V. Phone/Fax

Practice location:
  • Phone: 815-955-8042
  • Fax: 708-452-1444
Mailing address:
  • Phone: 872-400-6227
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHEL MALEK
Title or Position: OWNER
Credential: MD
Phone: 872-400-6227