Provider Demographics
NPI:1275167306
Name:DUPAGE SPINE AND ORTHOPAEDICS
Entity Type:Organization
Organization Name:DUPAGE SPINE AND ORTHOPAEDICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KOUTSKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-528-2000
Mailing Address - Street 1:950 N YORK RD STE 109
Mailing Address - Street 2:
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-8608
Mailing Address - Country:US
Mailing Address - Phone:630-528-2000
Mailing Address - Fax:
Practice Address - Street 1:950 N YORK RD STE 109
Practice Address - Street 2:
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-8608
Practice Address - Country:US
Practice Address - Phone:630-528-2000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-27
Last Update Date:2020-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Single Specialty