Provider Demographics
NPI:1023543105
Name:MODO SPIRA INC.
Entity Type:Organization
Organization Name:MODO SPIRA INC.
Other - Org Name:MODOSPIRA
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:TROY
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTHYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-805-2800
Mailing Address - Street 1:155 W BURTON PL
Mailing Address - Street 2:SUITE 207
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60610-1372
Mailing Address - Country:US
Mailing Address - Phone:312-805-2800
Mailing Address - Fax:312-471-1266
Practice Address - Street 1:155 W BURTON PL
Practice Address - Street 2:SUITE 207
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60610-1372
Practice Address - Country:US
Practice Address - Phone:312-805-2800
Practice Address - Fax:312-471-1266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-26
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Single Specialty