Provider Demographics
NPI:1366947236
Name:ADVANCED PAIN & SPINE MANAGEMENT, S.C.
Entity type:Organization
Organization Name:ADVANCED PAIN & SPINE MANAGEMENT, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:MACRINICI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-797-4888
Mailing Address - Street 1:121 S WILKE RD STE 110
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-1524
Mailing Address - Country:US
Mailing Address - Phone:847-797-4888
Mailing Address - Fax:847-739-0978
Practice Address - Street 1:121 S WILKE RD STE 110
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-1524
Practice Address - Country:US
Practice Address - Phone:847-797-4888
Practice Address - Fax:847-739-0978
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-24
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
No261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPainGroup - Multi-Specialty