Provider Demographics
NPI:1760626717
Name:ANTHONY S RINELLA M D S C
Entity Type:Organization
Organization Name:ANTHONY S RINELLA M D S C
Other - Org Name:ILLINOIS SPINE & SCOLIOSIS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:BENDFELDT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-694-7722
Mailing Address - Street 1:12701 W. 143RD STREET
Mailing Address - Street 2:SUITE 110
Mailing Address - City:HOMER GLEN
Mailing Address - State:IL
Mailing Address - Zip Code:60491-7721
Mailing Address - Country:US
Mailing Address - Phone:877-694-7722
Mailing Address - Fax:815-531-0055
Practice Address - Street 1:12701 W. 143RD STREET
Practice Address - Street 2:SUITE 110
Practice Address - City:HOMER GLEN
Practice Address - State:IL
Practice Address - Zip Code:60491-7721
Practice Address - Country:US
Practice Address - Phone:877-694-7722
Practice Address - Fax:815-531-0055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-21
Last Update Date:2010-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036106352207X00000X, 207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
No207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Single Specialty