Academic Spine Consultants, LLC

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

036113099 Issued in IL

Legal business name

ACADEMIC SPINE CONSULTANTS, LLC

Practice address

455 N Cityfront Plaza Dr Ste 3100
Chicago, IL 60611-5328

Phone

(312) 561-2329

Fax

(312) 561-2302

NPI assigned

Aug 17, 2018

Last updated

Aug 17, 2018By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Sergey Neckrysh, MD

Title

Director

Phone

(312) 450-5880

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1534464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534464000000",
    "number": "1740760826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 N CITYFRONT PLAZA DR STE 3100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606115328",
            "telephone_number": "312-561-2329",
            "fax_number": "312-561-2302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 N CITYFRONT PLAZA DR STE 3100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606115328",
            "telephone_number": "312-561-2329",
            "fax_number": "312-561-2302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACADEMIC SPINE CONSULTANTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-17",
        "last_updated": "2018-08-17",
        "status": "A",
        "authorized_official_last_name": "NECKRYSH",
        "authorized_official_first_name": "SERGEY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "312-450-5880",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": "IL",
            "license": "036113099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Neurological Surgery Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Neurological Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.