Provider Demographics
NPI:1255985891
Name:UNIVERSITY SPINE SURGEONS, LLC
Entity type:Organization
Organization Name:UNIVERSITY SPINE SURGEONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SERGEY
Authorized Official - Middle Name:
Authorized Official - Last Name:NECKRYSH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-561-2329
Mailing Address - Street 1:455 N CITYFRONT PLAZA DR STE 3100
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-5328
Mailing Address - Country:US
Mailing Address - Phone:312-561-2329
Mailing Address - Fax:312-577-0800
Practice Address - Street 1:20 N CLARK ST STE 3300
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-5089
Practice Address - Country:US
Practice Address - Phone:312-561-2329
Practice Address - Fax:312-577-0800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-31
Last Update Date:2020-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty