Provider Demographics
NPI:1578685368
Name:NEUROSURGERY SPINE & PAIN ASSOC PC
Entity Type:Organization
Organization Name:NEUROSURGERY SPINE & PAIN ASSOC PC
Other - Org Name:MIDWEST NEUROSURGERY & SPINE SPECIALISTS PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS MANAGER / TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:HILL
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:630-452-1467
Mailing Address - Street 1:3S220 WARREN AVE
Mailing Address - Street 2:
Mailing Address - City:WARRENVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60555-2914
Mailing Address - Country:US
Mailing Address - Phone:630-393-2222
Mailing Address - Fax:630-393-2221
Practice Address - Street 1:3S220 WARREN AVE
Practice Address - Street 2:
Practice Address - City:WARRENVILLE
Practice Address - State:IL
Practice Address - Zip Code:60555-2914
Practice Address - Country:US
Practice Address - Phone:630-393-2222
Practice Address - Fax:630-393-2221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036072169207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1316034010OtherDR. MATTHEW ROSS NPI
IL036072169Medicaid
IL036072169Medicaid
384010Medicare PIN