Organization
SPINE CONSULTANTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BAILEY BLYTHIN (PRACTICE ADMINISTRATOR)
(773) 321-2800
Entity
Organization
Contact information
Practice address
2514 VILLAGE GREEN PL, CHAMPAIGN, IL 61822-7675
(773) 321-2800
(773) 321-2801
Mailing address
2514 VILLAGE GREEN PL, CHAMPAIGN, IL 61822-7675
(773) 321-2800
(773) 321-2801
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
036094206
IL
Other
Enumeration date
11/16/2009
Last updated
12/20/2023
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