Provider Demographics
NPI:1891401667
Name:METRO CHICAGO SPINE & PAIN CONSULTANTS INC
Entity Type:Organization
Organization Name:METRO CHICAGO SPINE & PAIN CONSULTANTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MALEK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:815-955-8042
Mailing Address - Street 1:2 W DELAWARE PL UNIT 1907
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60610-3414
Mailing Address - Country:US
Mailing Address - Phone:815-955-8042
Mailing Address - Fax:708-452-1444
Practice Address - Street 1:5645 W ADDISON ST FL 2
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60634-4403
Practice Address - Country:US
Practice Address - Phone:815-955-8042
Practice Address - Fax:708-452-1444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-25
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty