# THE SPINE CENTER, S.C

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Lutheran General Spine Center, S.C
- **Organization subpart:** No

## Provider details

- **NPI number:** 1952307092
- **Authorized official:** DR. DAVID SPENCER M.D. (PRESIDENT)
- **Authorized official phone:** (847) 698-9330

## Contact information

- **Practice address:** 1875 DEMPSTER ST, STE 425, PARK RIDGE, IL 60068-1129
- **Practice address phone:** (847) 698-9330
- **Practice address fax:** (847) 698-1429
- **Mailing address:** 1875 DEMPSTER ST, STE 425, PARK RIDGE, IL 60068-1129
- **Mailing address phone:** (847) 698-9330
- **Mailing address fax:** (847) 698-1429

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |
| 207XS0117X | Orthopaedic Surgery of the Spine Physician | — | IL | — |

## Other

- **Enumeration date:** 06/23/2005
- **Last updated:** 07/21/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | CJ0089 | MEDICARE RAILROAD | IL |