Organization
THE SPINE CENTER, S.C
Active
Other names
Lutheran General Spine Center, S.C
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID SPENCER M.D. (PRESIDENT)
(847) 698-9330
Entity
Organization
Contact information
Practice address
1875 DEMPSTER ST, STE 425, PARK RIDGE, IL 60068-1129
(847) 698-9330
(847) 698-1429
Mailing address
1875 DEMPSTER ST, STE 425, PARK RIDGE, IL 60068-1129
(847) 698-9330
(847) 698-1429
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
207XS0117X
Orthopaedic Surgery of the Spine Physician
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CJ0089
MEDICARE RAILROAD
IL
Enumeration date
06/23/2005
Last updated
07/21/2022
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