Provider Demographics
NPI:1003856758
Name:NEUROLOGICAL SURGERY AND SPINE SURGERY S C
Entity Type:Organization
Organization Name:NEUROLOGICAL SURGERY AND SPINE SURGERY S C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:STEPHEN
Authorized Official - Last Name:ZELBY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-343-3566
Mailing Address - Street 1:1 WESTBROOK CORPORATE CENTER
Mailing Address - Street 2:STE 800
Mailing Address - City:WESTCHESTER
Mailing Address - State:IL
Mailing Address - Zip Code:60154-5703
Mailing Address - Country:US
Mailing Address - Phone:708-343-3566
Mailing Address - Fax:708-343-9235
Practice Address - Street 1:1 WESTBROOK CORPORATE CTR
Practice Address - Street 2:STE 800
Practice Address - City:WESTCHESTER
Practice Address - State:IL
Practice Address - Zip Code:60154-5701
Practice Address - Country:US
Practice Address - Phone:708-343-3566
Practice Address - Fax:708-343-9235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207T00000X
IL5553530001335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
No335E00000XSuppliersProsthetic/Orthotic SupplierGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1632283OtherBLUE SHIELD PROVIDER NUMB
IL139085200OtherDEPT OF LABOR
IL140007836OtherRAILROAD MEDICARE
CJ8518OtherRR MEDICARE DUPAGE CO
IL1632283OtherBLUE SHIELD PROVIDER NUMB
IL140007836OtherRAILROAD MEDICARE
IL5553530001Medicare NSC
IL201742Medicare PIN
CJ8518OtherRR MEDICARE DUPAGE CO
ILK91541Medicare PIN
IL207848Medicare PIN
ILK48929Medicare PIN
ILK23692Medicare PIN
ILL91542Medicare PIN
ILK02633Medicare PIN