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General NPI Number Information
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NPI Number | 1225193386
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Entity Type | Organization
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Legal Business Name | ORTHOPEDIC & SPINE SURGERY ASSOC
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Dates
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Enumeration Date | 12/27/2006
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Last Update Date | 06/20/2016
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Provider Practice Location Address
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Address Line | 2350 ROYAL BLVD SUITE 200
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City | ELGIN
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State | IL
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Zip | 60123-4718
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Country | US
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Telephone | 847-931-5300
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Fax | 847-931-9072
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Provider Business Mailing Address
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Address Line | 2350 ROYAL BLVD SUITE 200
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City | ELGIN
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State | IL
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Zip | 60123-4718
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Country | US
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Telephone | 847-931-5300
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Fax | 847-931-9072
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL GITELIS
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Credential |
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Telephone | 847-931-5300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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