INTERVENTIONAL PAIN MEDICINE LLC (NPI# 1639332505) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639332505 |
| Entity Type | Organization |
| Organization Name | INTERVENTIONAL PAIN MEDICINE LLC |
| Practice Address |
1 Bronze Pointe Blvd Suite 1-a Swansea IL 62226-1045 |
| Practice Telephone | 6182337055 |
| Mailing Telephone | 6182337055 |
| Enumeration Date | 2008-07-09 |
| Last Update Date | 2010-07-08 |
| Authorized Official Name | MRS. NAHEED T BASHIR (OWNER) |
| Authorized Official Telephone | 6182337055 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP3300X |
Clinic/Center Specialization: Pain |
036120409 | IL | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036120409 | 05 | |
| IL | BLUECROSS BLUE SHIELD | 8232343 | 01 |
| IL | HEALTHLINK | 869795 | 01 |
| Street Address |
1 BRONZE POINTE BLVD SUITE 1-A |
| City | SWANSEA |
| State | IL |
| Zip Code | 62226-1045 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861959694 | Sandra Howard | Counselor | 1 Bronze Pointe Blvd, Swansea, IL 62226-1045 | 2019-02-28 |
| 1710451802 | Cameron Young | Counselor | 1 Bronze Pointe Blvd, Swansea, IL 62226-1045 | 2019-01-11 |
| 1982177044 | Kerry Gallagher | Counselor | 1 Bronze Pointe Blvd, Swansea, IL 62226-1045 | 2019-01-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639778160 | Roxanna Lee Gunnels | Nurse Practitioner | 1 Bronze Pointe Plaza Suite 1a, Swansea, IL 62226 | 2020-10-26 |
| 1053969790 | Consistent Medical Transportation | Driver | 2012 N 17th St, Swansea, IL 62226 | 2019-08-27 |
| 1497314371 | Medi-plex Hospice of Illinois, LLC | Registered Nurse | 8 Park Place, Suite #3, Swansea, IL 62226 | 2019-06-13 |
| 1336617364 | Nicole Renee Schmidt | Speech-Language Pathologist | 150 N 27th St., Belleville, IL 62226 | 2018-11-07 |
| 1295258903 | Catherine Espino | Pharmacist | 11 Chambers Blvd, Swansea, IL 62226 | 2017-07-25 |
| 1366806838 | Kiley Faires | Nurse Practitioner | 4600 Memorial Drive Ste 360, Belleville, IL 62226 | 2016-04-11 |
| 1760857585 | Mvp Transportation | Non-emergency Medical Transport (VAN) | 1229 N 17th Street, Number 23, Belleville, IL 62226 | 2015-12-04 |
| 1275952566 | Aisha Danyale Franklin | Internal Medicine | 4261 Woodfield Pl, Belleville, IL 62226 | 2014-04-15 |
| 1396168332 | Jayne E. Ninness | Physical Therapy Assistant | 4500 Memorial Dr., Memorial Hospital, Belleville, IL 62226 | 2014-01-28 |
| 1053758193 | Gateway Foundation, Inc. | Clinic/Center | 1 Bronze Point, Suite 1, Swansea, IL 62226 | 2013-05-30 |
| Find all providers in zip 62226 | ||||
| Taxonomy Code | 261QP3300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Pain |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790244150 | Paradise Point Spa | Clinic/Center | 3207 Lake Ave Ste 13, Wilmette, IL 60091-1082 | 2019-03-15 |
| 1932610110 | Julia Rackley Perry Memorial Hospital | Clinic/Center | 530 Park Ave E Fl 3, Princeton, IL 61356-3901 | 2017-10-16 |
| 1538606470 | Naprapathy University | Clinic/Center | 320 E 21st St, Unit 405, Chicago, IL 60616-3190 | 2017-01-30 |
| 1306216403 | Chicago Pain and Wellness Institute S.c. | Clinic/Center | 665 W North Ave, Suite 101, Lombard, IL 60148-1134 | 2015-10-01 |
| 1134597636 | Great River Pain Clinic LLC | Clinic/Center | 555 N Kellogg St, Galesburg, IL 61401-3726 | 2015-09-14 |
| 1649651951 | Wellness Institute of Illinois, Ltd. | Clinic/Center | 741 S Mchenry Ave Ste G, Crystal Lake, IL 60014-7445 | 2015-06-11 |
| 1558618512 | Precision Diagnostics | Clinic/Center | 18623 81st Ave, Tinley Park, IL 60487-6279 | 2012-08-09 |
| 1962637157 | Interventional Pain Medicine of Jacksonville, LLC | Clinic/Center | 1440 West Walnut Street, Jacksonville, IL 62650-0000 | 2009-05-18 |
| 1952565384 | Aaa Headache and Pain Clinic Ltd | Clinic/Center | 1449 N Milwaukee Ave, Libertyville, IL 60048-1310 | 2008-07-15 |
| 1558583732 | Piasa Pain Center LLC | Clinic/Center | #3 Professional Drive, Suite B, Acton, IL 62002 | 2007-05-03 |
| Find all providers with the same taxonomy | ||||
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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.