# STRONG SPINE INSTITUTE, PLLC

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

## Provider details

- **NPI number:** 1902479132
- **Authorized official:** DMITRY NOVOSELETSKY MD (MANAGER)
- **Authorized official phone:** (773) 682-7661

## Contact information

- **Practice address:** 64 SHELDON LN, HIGHLAND PARK, IL 60035-5132
- **Practice address phone:** (773) 682-7661
- **Mailing address:** 64 SHELDON LN, HIGHLAND PARK, IL 60035-5132

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |
| 208VP0014X | Interventional Pain Medicine Physician | — | NULL | — |
| 208VP0014X | Interventional Pain Medicine Physician | — | — | — |

## Other

- **Enumeration date:** 07/24/2021
- **Last updated:** 07/26/2021