Provider Demographics
NPI:1871201319
Name:SPINE AND JOINT CENTER OF ILLINOIS PLLC
Entity type:Organization
Organization Name:SPINE AND JOINT CENTER OF ILLINOIS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MIGENA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAIMI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:224-329-5602
Mailing Address - Street 1:3115 N WILKE RD STE C
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-1451
Mailing Address - Country:US
Mailing Address - Phone:224-329-5602
Mailing Address - Fax:
Practice Address - Street 1:3115 N WILKE RD STE C
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-1451
Practice Address - Country:US
Practice Address - Phone:224-329-5602
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-14
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports MedicineGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Multi-Specialty