| Organization Name: | NEUROSPINAL CENTER |
| NPI Number: | 1194759142 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DREW S KANDILAKIS (CLINIC DIRECTOR) |
| Mailing Address: | 519 N Cass Ave 4th Floor Westmont |
| State: | IL US |
| Postal Code: | 605591514 |
| Phone Number: | 6309694355 |
| Fax Number: | 6309694527 |
| NPI Enumeration Date: | 07/10/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM1300X |
| License Number: | 60-002022 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Multi-Specialty |
| Taxonomy Definition: | |