PAIN SPECIALISTS OF ILLINOIS, S.C (NPI# 1699100859) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699100859 |
| Entity Type | Organization |
| Organization Name | PAIN SPECIALISTS OF ILLINOIS, S.C |
| Other Organization Name | ORTHO SPINE AND PAIN INSTITUTE |
| Practice Address |
1925 E 95th St Chicago IL 60617 |
| Mailing Address |
Po Box 3307 Oak Brook IL 60522-3307 |
| Practice Telephone | 6305711100 |
| Practice Fax Number | 6305046265 |
| Mailing Telephone | 6305711100 |
| Mailing Fax Number | 6305046265 |
| Enumeration Date | 2013-09-06 |
| Last Update Date | 2018-07-12 |
| Authorized Official Name | DR. SUNEELA HARSOOR (PRESIDENT) |
| Authorized Official Telephone | 6305711100 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 111N00000X | Chiropractor | Chiropractic Providers | ||
| N | 225100000X | Physical Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| Y | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Ortho Spine and Pain Institute | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2315 E 93rd St Ste 236, Chicago, IL 606173984 | 6305711100 | 6305046265 |
| 534 Chestnut St Ste 100, Hinsdale, IL 605213175 | 6305711100 | 6305046265 |
| Street Address |
1925 E 95TH ST |
| City | CHICAGO |
| State | IL |
| Zip Code | 60617 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639155807 | Mohamed Attia Ibrahim | Physical Therapist | 1925 E 95th St, Chicago, IL 60617-4710 | 2005-12-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871102921 | Manuel Lule | Physical Therapy Assistant | 9535 S Jeffery Boulevard, Chicago, IL 60617 | 2020-07-24 |
| 1083253546 | Vanaja Thotten | Internal Medicine | 8012 S.crandon Ave, Chicago, IL 60617 | 2020-01-02 |
| 1427527365 | Stony Island Dental PC | Dentist | 1600 E 93rd Street, Chicago, IL 60617 | 2018-11-21 |
| 1871060301 | Tamika Nicole Whitehead | Social Worker | 2822 East 83rd Street, Chicago, IL 60617 | 2018-11-02 |
| 1528543774 | Felicia Nwankwo | Nurse Practitioner | 2822 E 83rd Street Bradond Famiy Health Cener, Chicago, IL 60617 | 2018-10-03 |
| 1972099307 | David Phan | Optometrist | 1753 E 95th St Ste B-100, Chicago, IL 60617 | 2018-07-09 |
| 1831607340 | Pamela Evette Ewing | Counselor | 9145 S. Merrill Ave, Chicago, IL 60617 | 2018-01-18 |
| 1366976631 | Ali Mostafa Serhal | Radiology | 240 E. Huron St, Suite 1-203, Chicago, IL 60617 | 2017-04-13 |
| 1447784921 | 1915-25 95th St., LLC | Clinic/Center | 1915 E 95th St, Chicago, IL 60617 | 2017-04-12 |
| 1881140408 | Yeferson Laverde | Social Worker | 3062 East 31st, Chicago, IL 60617 | 2016-09-01 |
| Find all providers in zip 60617 | ||||
| Taxonomy Code | 208VP0014X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pain Medicine |
| Specialization | Interventional Pain Medicine |
| Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164940813 | Leonard Cerullo, Md, Ltd | Pain Medicine | 680 N Lake Shore Dr Ste 1428, Chicago, IL 60611-3461 | 2017-09-01 |
| 1417472887 | Kimberly Lynch | Pain Medicine | 5801 S Ellis Ave, Chicago, IL 60637-5418 | 2017-08-07 |
| 1538356233 | Lake Shore Therapy Center, Inc. | Pain Medicine | 2338 W Morse Ave, 1 A, Chicago, IL 60645-4767 | 2007-09-27 |
| 1497753214 | James R Diesfeld | Pain Medicine | 1044 N Francisco Ave Ste 404, Chicago, IL 60622-2743 | 2005-07-14 |
| 1043778731 | Kristin R Nelson | Pain Medicine | 1044 N Francisco Ave Ste 404, Chicago, IL 60622-2743 | 2019-03-12 |
| 1154777159 | Stellar Pain and Spine Specialists | Pain Medicine | 5215 N California Ave, Chicago, IL 60625-7014 | 2016-05-09 |
| 1629481940 | United Pain Consultants LLC | Pain Medicine | 6323 N Avondale Ave, Suite B-101, Chicago, IL 60631-1962 | 2014-06-04 |
| 1124327994 | Dearborn Medical Consultants, LLC | Pain Medicine | 712 N Dearborn St, Suite 200, Chicago, IL 60654-3818 | 2011-03-19 |
| 1659683373 | H & M Medical, Sc | Pain Medicine | 3633 W Fullerton Ave, Chicago, IL 60647-2344 | 2010-07-10 |
| 1063632917 | Professional Health Sport, Inc. | Pain Medicine | 6288 N Cicero Ave, Chicago, IL 60646-4918 | 2007-04-25 |
| Find all providers in CHICAGO | ||||
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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.