Organization
ADVANCED SPINAL CLINIC P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PATRICIA MARIE WASCO (PRESIDENT)
(773) 283-4700
Entity
Organization
Contact information
Practice address
5356 W ADDISON ST, CHICAGO, IL 60641-3356
(773) 283-4700
(773) 283-4848
Mailing address
5356 W ADDISON ST, CHICAGO, IL 60641-3356
(773) 283-4700
(773) 283-4848
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038-009263
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1627562
BCBS
IL
Enumeration date
05/21/2007
Last updated
06/11/2008
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