Provider Demographics
NPI:1174551782
Name:ALPINE SPINE & REHABILITATION GROUP
Entity type:Organization
Organization Name:ALPINE SPINE & REHABILITATION GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNIS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:847-726-2655
Mailing Address - Street 1:900 W MAIN ST
Mailing Address - Street 2:SUITE 160
Mailing Address - City:LAKE ZURICH
Mailing Address - State:IL
Mailing Address - Zip Code:60047-3416
Mailing Address - Country:US
Mailing Address - Phone:847-726-2655
Mailing Address - Fax:847-726-2654
Practice Address - Street 1:900 W MAIN ST
Practice Address - Street 2:SUITE 160
Practice Address - City:LAKE ZURICH
Practice Address - State:IL
Practice Address - Zip Code:60047-3416
Practice Address - Country:US
Practice Address - Phone:847-726-2655
Practice Address - Fax:847-726-2654
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILT38539Medicare UPIN
IL211039Medicare ID - Type UnspecifiedGROUP NUMBER
ILK14875Medicare ID - Type UnspecifiedINDIVIDUAL NUMBER