NPI 1417208331 · live from the CMS NPI Registry
Advanced Spine And Pain Specialists, S.C.
Anesthesiology, Pain Medicine in Chicago, IL. National Provider Identifier 1417208331, active.
NPI record
| NPI | 1417208331 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Anesthesiology, Pain Medicine 207LP2900X |
| Practice location | 6524 W Archer Ave, Chicago, IL 60638 |
| Practice phone | 773-717-0890 |
| Enumerated | October 2, 2012 |
| Last updated | June 17, 2020 |
| Authorized official | Krishna Chunduri, President |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Chiropractor | 111N00000X | — |
| Physical Therapist | 225100000X | — |
| Anesthesiology, Pain Medicine primary | 207LP2900X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.