MEDICARE: ACADEMIC SPINE CONSULTANTS, LLC

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
1	207T00000X	Neurological Surgery Physician	036113099	IL

General Provider Information

NPI Number	:	1740760826
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACADEMIC SPINE CONSULTANTS, LLC

Provider Business Mailing Address
First Line	:	455 N CITYFRONT PLAZA DR STE 3100
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-5328
Country	:	US
Telephone Number	:	312-561-2329
Fax Number	:	312-561-2302

Provider Business Practice Location Address
First Line	:	455 N CITYFRONT PLAZA DR STE 3100
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-5328
Country	:	US
Telephone Number	:	312-561-2329
Fax Number	:	312-561-2302

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DR. SERGEY NECKRYSH
Credential	:	MD
Telephone Number	:	312-450-5880

Provider Enumeration Date	:	08/17/2018
Last Update Date	:	08/17/2018

Similar Medicare Providers

1740004910 — WOCC, NFP
Practice Location Address:

3648 W BELMONT AVE
CHICAGO, IL
60618-5328

Practice Phone: 773-900-9622
Practice Fax:

1447565072 — TOTAL RENAL CARE INC
Practice Location Address:

5060 S STATE ST
CHICAGO, IL
60609-5328

Practice Phone: 773-285-1840
Practice Fax: 773-285-3485

1730623786 — A NEW AGE HUMAN SERVICES CORP.
Practice Location Address:

5328 W PARKER AVE
CHICAGO, IL
60639-1521

Practice Phone: 773-237-8793
Practice Fax: 708-575-5903

1790261907 — CAMESHA LYNETTE JONES- BRANDON LCSW
Practice Location Address:

5022 S STATE ST
CHICAGO, IL
60609-5328

Practice Phone: 708-292-8730
Practice Fax:

1871102293 — MRS. SONIA ECHEVARRIA RRT
Practice Location Address:

5328 S MCVICKER AVE
CHICAGO, IL
60638-2634

Practice Phone: 773-654-0419
Practice Fax:

1649865445 — CORAL NUTRITION COACH, LLC
Practice Location Address:

5415 S DORCHESTER AVE APT BSMT
CHICAGO, IL
60615-5328

Practice Phone: 773-710-2237
Practice Fax: 872-244-3810

Directions to “ACADEMIC SPINE CONSULTANTS, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.