# FOUNDATION SPORT & SPINE, INC.

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

## Provider details

- **NPI number:** 1609211218
- **Authorized official:** DR. NATHAN JON PORCHER DC (PRESIDENT/OWNER)
- **Authorized official phone:** (847) 342-3000

## Contact information

- **Practice address:** 415 W GOLF RD STE 12, ARLINGTON HEIGHTS, IL 60005-3923
- **Practice address phone:** (847) 342-3000
- **Practice address fax:** (847) 342-3495
- **Mailing address:** 415 W GOLF RD STE 12, ARLINGTON HEIGHTS, IL 60005-3923
- **Mailing address phone:** (847) 342-3000
- **Mailing address fax:** (847) 342-3495

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | 038012410 | IL | Yes |

## Other

- **Enumeration date:** 05/08/2013
- **Last updated:** 03/17/2018