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General NPI Number Information
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NPI Number | 1215133657
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Entity Type | Organization
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Legal Business Name | ORTHOPAEDIC AND SPINE SURGERY CENTER,LTD
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Dates
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Enumeration Date | 06/22/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1200 S YORK RD SUITE 4290
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City | ELMHURST
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State | IL
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Zip | 60126
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Country | US
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Telephone | 773-296-3900
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Fax | 773-296-3901
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Provider Business Mailing Address
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Address Line | 3000 N HALSTED ST SUITE 611
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City | CHICAGO
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State | IL
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Zip | 60657
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Country | US
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Telephone | 773-296-3900
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Fax | 773-296-3901
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. MIRIAM J GONZALES
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Credential |
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Telephone | 773-296-3900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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