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General NPI Number Information
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NPI Number | 1295811065
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Entity Type | Organization
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Legal Business Name | VAN ORTHOPAEDIC & SPINE SURGERY SC
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Dates
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Enumeration Date | 10/27/2006
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Last Update Date | 01/23/2009
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Provider Practice Location Address
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Address Line | 351 DELNOR DR SUITE 406
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City | GENEVA
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State | IL
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Zip | 60134-4220
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Country | US
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Telephone | 630-208-3099
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Fax | 630-208-4373
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Provider Business Mailing Address
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Address Line | 351 DELNOR DR SUITE 406
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City | GENEVA
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State | IL
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Zip | 60134-4220
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Country | US
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Telephone | 630-208-3099
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Fax | 630-208-4373
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ALAN U VAN
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Credential | MD
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Telephone | 630-262-8557
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 036090742
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License Number State | IL
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