Provider Demographics
NPI:1588319719
Name:MSPS SURGICAL INC.
Entity type:Organization
Organization Name:MSPS SURGICAL INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:FRONT OFFICE
Authorized Official - Middle Name:
Authorized Official - Last Name:MANAGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-915-2622
Mailing Address - Street 1:3412 KELLER LN
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60565-3561
Mailing Address - Country:US
Mailing Address - Phone:630-915-2622
Mailing Address - Fax:630-378-4592
Practice Address - Street 1:1999 SPRINGBROOK SQUARE DR STE 101
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60564-5962
Practice Address - Country:US
Practice Address - Phone:630-915-2622
Practice Address - Fax:630-378-4592
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-16
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty