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General NPI Number Information
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NPI Number | 1578628640
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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 | 04/17/2015
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Provider Practice Location Address
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Address Line | 420 W NORTHWEST HWY SUITE M
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City | BARRINGTON
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State | IL
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Zip | 60010-6837
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Country | US
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Telephone | 847-382-6766
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Fax | 847-382-6782
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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 | 60123-4719
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Country | US
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Telephone | 847-931-5300
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Fax | 847-931-5321
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | BARBARA ROUSE
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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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