# ADVANCED SPINE AND PAIN SPECIALISTS, S.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417208331
- **Authorized official:** KRISHNA C CHUNDURI MD (PRESIDENT)
- **Authorized official phone:** (312) 952-2226

## Contact information

- **Practice address:** 6524 W ARCHER AVE, CHICAGO, IL 60638-2400
- **Practice address phone:** (773) 717-0890
- **Practice address fax:** (866) 585-0302
- **Mailing address:** 6524 W ARCHER AVE, CHICAGO, IL 60638-2400
- **Mailing address phone:** (773) 717-0890
- **Mailing address fax:** (866) 585-0302

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | — | NULL | — |
| 111N00000X | Chiropractor | — | — | — |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | Yes |
| 225100000X | Physical Therapist | — | NULL | — |
| 225100000X | Physical Therapist | — | — | — |

## Other

- **Enumeration date:** 10/02/2012
- **Last updated:** 06/17/2020