Provider Demographics
NPI:1770524670
Name:NEUROLOGICAL SURGERY AND SPINE SURGERY S C
Entity type:Organization
Organization Name:NEUROLOGICAL SURGERY AND SPINE SURGERY S C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:STEPHEN
Authorized Official - Last Name:ZELBY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-343-3566
Mailing Address - Street 1:1 WESTBROOK CORPORATE CTR
Mailing Address - Street 2:STE 800
Mailing Address - City:WESTCHESTER
Mailing Address - State:IL
Mailing Address - Zip Code:60154-5701
Mailing Address - Country:US
Mailing Address - Phone:708-343-3566
Mailing Address - Fax:708-223-1429
Practice Address - Street 1:1 WESTBROOK CORPORATE CENTER
Practice Address - Street 2:STE 800
Practice Address - City:WESTCHESTER
Practice Address - State:IL
Practice Address - Zip Code:60154-5703
Practice Address - Country:US
Practice Address - Phone:708-343-3566
Practice Address - Fax:708-343-9235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL5553530001332B00000X
IL207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1632283OtherBLUE SHIELD
ILCJ8518OtherRR MEDICARE COOK COUNTY
IL140007836OtherRAILROAD MEDICARE
ILL91183Medicare PIN
IL201545Medicare PIN
IL5553530001Medicare NSC
ILK47128Medicare PIN
IL140007836OtherRAILROAD MEDICARE
ILCJ8518OtherRR MEDICARE COOK COUNTY
ILL91184Medicare PIN
IL207836Medicare PIN
IL1632283OtherBLUE SHIELD
ILK36866Medicare PIN
ILK48928Medicare PIN