Organization
CHICAGO SPINE AND JOINT, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXIS GOEDERT (CEO)
(815) 416-1224
Entity
Organization
Contact information
Practice address
907 N ELM ST STE 101, HINSDALE, IL 60521-3644
(708) 482-4500
(708) 482-4502
Mailing address
907 N ELM ST STE 101, HINSDALE, IL 60521-3644
(708) 482-4500
(708) 482-4502
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
—
—
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01608719
BLUE CROSS GRP ILLINOIS
IL
01
—
050054545
MEDICARE RAILROAD
IL
01
—
050054546
MEDICARE RAILROAD
IL
01
—
132321800
US DEPT LABOR
IL
01
—
720000088
MEDICARE RAILROAD
IL
01
—
720000089
MEDICARE RAILROAD
IL
Enumeration date
07/01/2006
Last updated
01/29/2026
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