Advanced Spine And Pain Specialists, S.C.
Anesthesiology, Pain Medicine in Chicago, IL. Organization (NPI-2).
NPI number1417208331
StatusActive
Last updated in NPPESJun 17, 2020
Details
- NPI
- 1417208331
- Entity type
- Organization (NPI-2)
- Legal business name
- Advanced Spine And Pain Specialists, S.C.
- Organization subpart
- No
- Enumeration date
- Oct 2, 2012
- Certification date
- Jun 17, 2020
- Last updated
- Jun 17, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207LP2900X | Anesthesiology, Pain Medicine | – | – | Yes |
| 111N00000X | Chiropractor | – | – | |
| 225100000X | Physical Therapist | – | – |
Practice location
6524 W Archer AveChicago, IL 60638-2400
Phone 773-717-0890 · Fax 866-585-0302
Mailing address
6524 W Archer AveChicago, IL 60638-2400
Phone 773-717-0890 · Fax 866-585-0302
Authorized official
Krishna C Chunduri
President
3129522226
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