Organization
MIDWEST SPORTS AND INTERVENTIONAL SPINE SC
Active
Organization
MIDWEST SPORTS AND INTERVENTIONAL SPINE SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CYRIL N PHILIP MD (OWNER)
(847) 343-0711
Entity
Organization
Contact information
Practice address
850 GENEVA PKWY N STE 100, LAKE GENEVA, WI 53147-4562
(262) 299-6199
(262) 293-6953
Mailing address
2070 GREEN BAY RD STE 163, HIGHLAND PARK, IL 60035-2412
(262) 299-6199
(262) 293-6953
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
Other
Enumeration date
10/01/2025
Last updated
10/01/2025
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