Provider Demographics
NPI:1427745223
Name:SPINE TECH, INC
Entity type:Organization
Organization Name:SPINE TECH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:TRISTANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-542-0077
Mailing Address - Street 1:197 KIMBERLY RD
Mailing Address - Street 2:
Mailing Address - City:NORTH BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-2252
Mailing Address - Country:US
Mailing Address - Phone:773-621-2255
Mailing Address - Fax:
Practice Address - Street 1:111 LIONS DR STE 207
Practice Address - Street 2:
Practice Address - City:BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-3175
Practice Address - Country:US
Practice Address - Phone:773-621-2255
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-20
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center