North Suburban Pain and Spine Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

NORTH SUBURBAN PAIN AND SPINE CENTER LLC

Practice address

9700 Golf Rd
Des Plaines, IL 60016

Phone

(773) 752-6340

NPI assigned

Feb 3, 2020

Last updated

Aug 31, 2021By 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

Melissa M Rice

Title

Adminstrator

Phone

(224) 500-3339

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1770114290. Details of each certification follow.

• CCN 14C0001192 Ambulatory surgical center · Active · Name & address match · Details

Ambulatory surgical center certification: CCN 14C0001192

Legal name

North Suburban Pain and Spine Center, LLC

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Nov 1, 2022

Last certification

Oct 21, 2022

Ownership / control type

Proprietary

Facility address

9700 Golf Road
Des Plaines, IL 60016

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1580688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630368000000",
    "number": "1770114290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9700 GOLF RD",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "60016",
            "telephone_number": "847-450-0881",
            "fax_number": "847-789-7338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9700 GOLF RD",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "60016",
            "telephone_number": "773-752-6340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH SUBURBAN PAIN AND SPINE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-03",
        "last_updated": "2021-08-31",
        "certification_date": "2020-09-25",
        "status": "A",
        "authorized_official_last_name": "RICE",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ADMINSTRATOR",
        "authorized_official_telephone_number": "224-500-3339"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ambulatory Surgical Clinic/Center in Des Plaines, IL
• Providers in Des Plaines, IL by specialty
• Ambulatory Surgical Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.