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Organization
ORTHO SPINE SURGICAL LLC
Active
Organization
ORTHO SPINE SURGICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MOHAMED S SIRAJUDEEN (PRESIDENT)
(773) 761-0500
Entity
Organization
Contact information
Practice address
1925 E 95TH ST STE 220, CHICAGO, IL 60617-4710
(773) 761-0500
(773) 761-1355
Mailing address
1925 E 95TH ST STE 220, CHICAGO, IL 60617-4710
(773) 761-0500
(773) 761-1355
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
NULL
Other
Enumeration date
09/08/2020
Last updated
09/08/2020
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