Azhar M Kothawala (NPI# 1891042552, PAC ID# 7214232669) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERVENTIONAL PAIN MANAGEMENT.
| Nation Provider ID (NPI) | 1891042552 |
| PAC ID by PECOS | 7214232669 |
| Professional Enrollment ID | I20160809001255 |
| Full Name | Azhar M Kothawala |
| Organization Legal Name | MEDICAL PAIN MANAGEMENT SERVICES, LTD. |
| Address |
1235 N Mulford Rd Suite 222 Rockford IL 61107-3879 |
| Phone Number | 8153978400 |
| Gender | M |
| Medical School | UNIVERSITY OF ILLINOIS AT CHICAGO HEALTH SCIENCE CENTER |
| Graduation Year | 2011 |
| Primary Specialty | INTERVENTIONAL PAIN MANAGEMENT |
| Secondary Specialties | ANESTHESIOLOGY |
| Group Practice PAC ID | 4284693755 |
| Number of Group Practice Members | 5 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 140233 | OSF SAINT ANTHONY MEDICAL CENTER |
| 140012 | KATHERINE SHAW BETHEA HOSPITAL |
| 141312 | ROCHELLE COMMUNITY HOSPITAL |
| 140228 | SWEDISH AMERICAN HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 2202 Harlem Rd, Suite 200, Loves Park, IL 61111-2754 | 8158774848 | ROCKFORD ANESTHESIOLOGISTS ASSOCIATED LLC |
| 1235 N Mulford Rd, Suite 222, Rockford, IL 61107-3879 | 8153978400 | MEDICAL PAIN MANAGEMENT SERVICES, LTD. |
| Organization Legal Name | MEDICAL PAIN MANAGEMENT SERVICES, LTD. |
| Physicians | 5 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| William S Minore | Interventional Pain Management | Medical Pain Management Services, Ltd. | 1235 N Mulford Rd, Suite 222, Rockford, IL 61107-3879 |
| Daniel R Green | Nurse Practitioner | Medical Pain Management Services, Ltd. | 1045 W Stephenson St, Freeport, IL 61032-4864 |
| Howard W Weiss | Interventional Pain Management | Medical Pain Management Services, Ltd. | 1045 W Stephenson St, Freeport, IL 61032-4864 |
| Virginia L Velazquez | Nurse Practitioner | Medical Pain Management Services, Ltd. | 403 E 1st St, Dixon, IL 61021-3116 |
| Street Address |
1235 N MULFORD RD SUITE 222 |
| City | ROCKFORD |
| State | IL |
| Zip | 61107-3879 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| William S Minore | Interventional Pain Management | Medical Pain Management Services, Ltd. | 1235 N Mulford Rd, Suite 222, Rockford, IL 61107-3879 |
| Bryn Maxine Byers Krause | Nurse Practitioner | Surgical Services of Illinois, Sc | 1235 N Mulford Rd, Suite 205, Rockford, IL 61107-3879 |
| Melissa L Stenstrom | Dermatology | Surgical Services of Illinois, Sc | 1235 N Mulford Rd, Suite 205, Rockford, IL 61107-3879 |
| Andrew J Blint | Orthopedic Surgery | 1235 N Mulford Rd, Suite 103, Rockford, IL 61107-3879 | |
| Susan Mary Fowell | Ophthalmology | 1235 N Mulford Rd, Rockford, IL 61107-3879 | |
| Andrew I Jun | Otolaryngology | Surgical Services of Illinois, Sc | 1235 N Mulford Rd, Suite 205, Rockford, IL 61107-3879 |
| Lori A Schultz | Nurse Practitioner | Surgical Services of Illinois, Sc | 1235 N Mulford Rd, Suite 205, Rockford, IL 61107-3879 |
| Peggy W Shiels | Internal Medicine | Jack W. Lenox, Ltd | 1235 N Mulford Rd, Rockford, IL 61107-3879 |
| Lucy W Martin | Nurse Practitioner | Jack W. Lenox, Ltd | 1235 N Mulford Rd, Suite 200, Rockford, IL 61107-3879 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Amy Hultman | Clinical Social Worker | 4320 Spring Creek Rd, Suite 9, Rockford, IL 61107-1157 | |
| Casey Jane Pilcher | Clinical Social Worker | 4320 Spring Creek Rd, Suite 18, Rockford, IL 61107-1158 | |
| Christine Blake Feathers | Clinical Social Worker | 4320 Spring Creek Rd, Rockford, IL 61107-1175 | |
| Roger H Hill | Optometry | Primary Eye Care Centers PC | 1603 N Alpine Rd, Suite 121, Rockford, IL 61107-1439 |
| Vasana Lerdvoratavee | Optometry | Primary Eye Care Centers PC | 1603 N Alpine Rd, Suite 121, Rockford, IL 61107-1439 |
| Ronald Weingart | Optometry | Primary Eye Care Centers PC | 1603 N Alpine Rd, Suite 121, Rockford, IL 61107-1439 |
| Kelly A Kalt | Clinical Social Worker | 1639 N Alpine Rd, Suite 403, Rockford, IL 61107-1440 | |
| Amira Al-basha | Physician Assistant | Edgebrook Dermatology P.C. | 1639 N Alpine Rd, Suite 380, Rockford, IL 61107-1440 |
| Maria Albasha | Dermatology | Edgebrook Dermatology P.C. | 1639 N Alpine Rd, Suite 380, Rockford, IL 61107-1440 |
| Stephen D Beaman | Clinical Social Worker | 1639 N Alpine Rd, Suite 403, Rockford, IL 61107-1440 | |
| Find all physicians in zip 61107 | |||
| City | ROCKFORD |
| Zip Code | 61107 |
| Specialty | INTERVENTIONAL PAIN MANAGEMENT |
| City + Specialty | ROCKFORD + INTERVENTIONAL PAIN MANAGEMENT |
Please comment or provide details below to improve the information on Azhar M Kothawala.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.