Organization
HEGEWISCH SPINE PAIN CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NATALYA SMIRNOVA (OFFICE MANAGER)
(708) 788-7246
Entity
Organization
Contact information
Practice address
6626 W CERMAK RD, BERWYN, IL 60402
(708) 788-7246
Mailing address
7653 W MONTROSE AVE, NORRIDGE, IL 60706
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
036108759
IL
Other
Enumeration date
03/03/2016
Last updated
03/03/2016
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