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NPI Code Detail

MEDICARE: CHICAGO SPINE AND SPORTS, P.C.

MEDICARE: CHICAGO SPINE AND SPORTS, P.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111NX0800XOrthopedic Chiropractor038009427IL

General Provider Information

NPI Number : 1538469184
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHICAGO SPINE AND SPORTS, P.C.
Provider Business Mailing Address
First Line : 922 W DIVERSEY PKWY
Second Line :
City : CHICAGO
State : IL
Zip : 60614-1416
Country : US
Telephone Number : 773-529-0057
Fax Number : 773-529-0231
Provider Business Practice Location Address
First Line : 922 W DIVERSEY PKWY
Second Line :
City : CHICAGO
State : IL
Zip : 60614-1416
Country : US
Telephone Number : 773-529-0057
Fax Number : 773-529-0231
Authorized Official
Title or Position : DOCTOR
Name : DR. DOUGLAS KREBS
Credential : DC, FACO, CSCS
Telephone Number : 773-529-0057
Provider Enumeration Date : 10/29/2010
Last Update Date : 03/18/2024

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Directions to “CHICAGO SPINE AND SPORTS, P.C. ” Practice Location

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