Provider Demographics
NPI:1356035182
Name:ALIF SPINE ACCESS, LLC
Entity type:Organization
Organization Name:ALIF SPINE ACCESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MINH
Authorized Official - Middle Name:
Authorized Official - Last Name:LUU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-680-2515
Mailing Address - Street 1:183 N ADDISON AVE APT 411
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-3198
Mailing Address - Country:US
Mailing Address - Phone:312-952-4998
Mailing Address - Fax:
Practice Address - Street 1:183 N ADDISON AVE APT 411
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-3198
Practice Address - Country:US
Practice Address - Phone:312-952-4998
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-05
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty