Illinois Valley Spine Institute Llc
LBN: Illinois Valley Spine Institute Llc
Illinois Valley Spine Institute Llc is an health care organization with primary practice located at 4231 Progress Blvd 4, Peru IL 61354-1193. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery of the Spine, which is considered as the primary health care specialty.
Illinois Valley Spine Institute Llc can be contacted via phone (815) 780-8627, or through Bergandi, Jason via phone (815) 780-8627.
Contact Information
Primary practice address
4231 Progress Blvd 4
Peru IL 61354-1193
Phone: (815) 780-8627
Fax: (815) 780-8630
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery of the Spine | 207XS0117X | 036-114114 | Illinois |
Profile Details
| NPI number | 1336428192 |
|---|---|
| LBN Legal business name | Illinois Valley Spine Institute Llc |
| DBA Doing business as | |
| Authorized official | Bergandi, Jason Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Aug 11th, 2011 |
| Last updated | Nov 28th, 2011 - about 13 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1336428192 | NPPES |
| Illinois | MEDICAID | 036-114114 | |
| Illinois | Other | IL6014 |
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