Provider Demographics
NPI:1144781584
Name:ORTHOPAEDIC SPINE INSTITUTE SC
Entity Type:Organization
Organization Name:ORTHOPAEDIC SPINE INSTITUTE SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VIVEK
Authorized Official - Middle Name:
Authorized Official - Last Name:MOHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-381-1381
Mailing Address - Street 1:800 E WOODFIELD RD STE 111
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-4763
Mailing Address - Country:US
Mailing Address - Phone:630-381-1381
Mailing Address - Fax:630-381-1385
Practice Address - Street 1:800 E WOODFIELD RD STE 111
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4763
Practice Address - Country:US
Practice Address - Phone:630-381-1381
Practice Address - Fax:630-381-1385
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-28
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Single Specialty