Provider Demographics
NPI:1871700302
Name:NEUROSURGICAL PROFESSIONALS, LTD.
Entity type:Organization
Organization Name:NEUROSURGICAL PROFESSIONALS, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHAFFER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-704-0177
Mailing Address - Street 1:25 E WASHINGTON ST
Mailing Address - Street 2:SUITE 1329
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60602-1708
Mailing Address - Country:US
Mailing Address - Phone:312-704-0177
Mailing Address - Fax:312-704-1938
Practice Address - Street 1:25 E WASHINGTON ST
Practice Address - Street 2:SUITE 1329
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-1708
Practice Address - Country:US
Practice Address - Phone:312-704-0177
Practice Address - Fax:312-704-1938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0001617222OtherBCBS
IL0859703OtherAETNA
IL0859703OtherAETNA
ILD15670Medicare UPIN
IL0859703OtherAETNA