Healthcare Provider Details

I. General information

NPI: 1972412492
Provider Name (Legal Business Name): BOTTI SPORTS & SPINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

64 ORLAND SQUARE DRIVE, UNIT 314A
ORLAND PARK IL
60462
US

IV. Provider business mailing address

64 ORLAND SQUARE DRIVE, UNIT 314A
ORLAND PARK IL
60462
US

V. Phone/Fax

Practice location:
  • Phone: 708-717-5947
  • Fax: 708-942-8839
Mailing address:
  • Phone: 708-717-5947
  • Fax: 708-942-8839

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number StateNULL

VIII. Authorized Official

Name: VALENTINO R BOTTI
Title or Position: OWNER/PROVIDER
Credential: D.C.
Phone: 708-717-5947