INTERVENTIONAL PAIN MANAGEMENT, LTD. (NPI# 1033155080) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033155080 |
| Entity Type | Organization |
| Organization Name | INTERVENTIONAL PAIN MANAGEMENT, LTD. |
| Practice Address |
10220 Wicker Ave Suite 3 Saint John IN 46373-9424 |
| Mailing Address |
18221 Torrence Ave Suite 1c Lansing IL 60438-2870 |
| Practice Telephone | 2195156943 |
| Mailing Telephone | 7088959450 |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2016-01-19 |
| NPI Deactivation Date | 08/28/2013 |
| NPI Reactivation Date | 2015-10-14 |
| Authorized Official Name | PAUL C POLLACHEK (ADMINISTRATOR) |
| Authorized Official Telephone | 7084747650 |
| Authorized Official Credential | RN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 60548471 | IL | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891726345 | Interventional Pain Management, Ltd. | Anesthesiology | 18221 Torrence Ave, Suite 1b, Lansing, IL 60438-2870 | 2006-07-05 |
| Street Address |
10220 WICKER AVE SUITE 3 |
| City | SAINT JOHN |
| State | IN |
| Zip Code | 46373-9424 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821462243 | Stat Anesthesia Specialists, Ltd | Pain Medicine | 10220 Wicker Ave, Suite 3, Saint John, IN 46373-9424 | 2015-11-23 |
| 1407227085 | Transitions Counseling Center | Counselor | 10220 Wicker Ave, 3, Saint John, IN 46373-9424 | 2015-10-08 |
| 1134397771 | Abigail Ann Ercoli | Counselor | 10220 Wicker Ave, Suite 3, Saint John, IN 46373-9424 | 2008-02-18 |
| 1699724781 | Stat Anesthesia Specialists Ltd | Anesthesiology | 10220 Wicker Ave, Suite 3, Saint John, IN 46373-9424 | 2006-05-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023641123 | Lisa A Arteaga | Occupational Therapy Assistant | 10700 Park Place of St John, St John, IN 46373 | 2020-02-17 |
| 1306493507 | Athletico Ltd | Physical Therapist | 10081 Wicker Ave #4, Saint John, IN 46373 | 2019-08-22 |
| 1083014971 | Courtney Olavarria | Registered Nurse | 8915 West 93rd Avenue, Clark Middle School, Saint John, IN 46373 | 2014-08-27 |
| 1316368111 | Tracy Lynn Wargo | Registered Nurse | 8801 Wicker Ave., Kolling Elementary, St. John, IN 46373 | 2013-12-20 |
| 1245587989 | Joshua Dejong | Physical Therapist | 10200 Wicker Ave Ste 1, Saint John, IN 46373 | 2012-08-13 |
| 1053406629 | Corlin Alden Stein | Chiropractor | 9161 Wicker Avenue (us 41), St. John, IN 46373 | 2006-10-03 |
| 1235190216 | Tarak R Chokshi | Internal Medicine | 10200 Wicker Avenue, St John, IN 46373 | 2006-03-30 |
| 1154397057 | Norbert A Matulis | Dentist | 9207 Wicker Avenue, St John, IN 46373 | 2006-02-28 |
| 1568462729 | Keith R. Pitchford | Orthopaedic Surgery | 9615 Keilman Street, Saint John, IN 46373 | 2005-07-28 |
| 1528483021 | Creating Smiles PC | Dentist | 8217 Wicker Ave, St John, IN 46373 | 2014-02-20 |
| Find all providers in zip 46373 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
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| 1194354274 | Center for Vascular Medicine In LLC | Specialist | 33 E County Line Rd Ste D, Greenwood, IN 46143-1078 | 2020-04-02 |
| 1659903599 | Ann M Samra-theurer | Specialist | 3988 Cobblestone Cv, New Haven, IN 46774-2078 | 2020-02-09 |
| 1780223750 | Erin Cannon | Specialist | 1543 N Post Rd, Indianapolis, IN 46219 | 2019-12-23 |
| 1508320318 | Andrea Carlson | Specialist | 3570 E Lincoln Hwy, Merrillville, IN 46410-5830 | 2019-01-25 |
| 1144708413 | Inject Health, LLC | Specialist | 1833 N Shadeland Ave, Indianapolis, IN 46219-2735 | 2018-07-30 |
| 1679078398 | Wright Choice Hairquarters | Specialist | 1815 Fox Point Trl Apt 2, Fort Wayne, IN 46816-2450 | 2018-03-26 |
| 1053819458 | Denise Michelle Strom | Specialist | 8620 Purdue Rd, Indianapolis, IN 46268-1114 | 2018-01-31 |
| 1568995785 | Southlake Internal Medicine LLC | Specialist | 928 Mary Ellen Dr, Crown Point, IN 46307-8998 | 2017-04-05 |
| 1679010342 | Kathryn Dittmer | Specialist | 3411 Airport Rd, Portage, IN 46368-5107 | 2017-01-19 |
| 1225581945 | Hossam Eldine Kamal Youssef | Specialist | 7230 Engle Rd Ste 303, Fort Wayne, IN 46804-2227 | 2016-07-28 |
| Find all providers with the same taxonomy | ||||
| City | SAINT JOHN |
| Zip Code | 46373 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.