Advanced Spinal Orthotics

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

036111342 Issued in IL

Legal business name

ADVANCED SPINAL ORTHOTICS

Practice address

3000 N Halsted St
Suite 703
Chicago, IL 60657-5188

Phone

(773) 770-5980

Fax

(773) 296-9999

NPI assigned

Dec 7, 2012

Last updated

Dec 7, 2012By 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. John K Song, MD

Title

Direct Owner

Phone

(773) 770-5980

Specialties & licenses 1

Addresses

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

Medicare medical equipment & supply locations

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

{
    "created_epoch": "1354838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354838400000",
    "number": "1861737462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 N HALSTED ST",
            "address_2": "SUITE 703",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575188",
            "telephone_number": "773-770-5980",
            "fax_number": "773-296-9999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 N HALSTED ST",
            "address_2": "SUITE 703",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575188",
            "telephone_number": "773-770-5980",
            "fax_number": "773-296-9999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED SPINAL ORTHOTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-07",
        "last_updated": "2012-12-07",
        "status": "A",
        "authorized_official_last_name": "SONG",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "DIRECT OWNER",
        "authorized_official_telephone_number": "773-770-5980",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IL",
            "license": "036111342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Advanced Women's Health of Chicago, SC
• Advantage Dental Care, LLC

• Durable Medical Equipment & Medical Supplies in Chicago, IL
• Providers in Chicago, IL by specialty
• Durable Medical Equipment & Medical Supplies in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.