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RUSH NORTH SHORE PAIN CENTER NPI 1992923304


NPI Information

NPI: 1992923304
Provider Name: RUSH NORTH SHORE PAIN CENTER
Classification: Psychologist - 103TP0016X
Entity Type: Organization

Specialization: Prescribing (Medical)

Address:
9701 KNOX AVE
SUITE 103
SKOKIE, IL
ZIP 60076
Phone: (847) 933-6974
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RUSH NORTH SHORE PAIN CENTER is a prescribing (medical) psychologist in Skokie, IL. The provider is a licensed, doctoral-level psychologist authorized to prescribe and has undergone specialized education and training in preparation for prescriptive practice and has passed an examination accepted by the state board of psychology relevant to establishing competence for prescribing, and has received from the state board of psychology a current certificate granting prescriptive authority, which has not been revoked or suspended. RUSH NORTH SHORE PAIN CENTER NPI is 1992923304. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

9701 KNOX AVE
SUITE 103
SKOKIE, IL
ZIP 60076-256
Phone: (847) 933-6974

The provider's authorized official is Anthony Ivankovich .
The authorized official title is Director Of Pain Center and has the following contact phone number (312) 942-3135.

The enumeration date for this NPI number is 4/23/2007 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1103TP0016XPsychologistPrescribing (Medical)Yes
2207L00000XAnesthesiologyX
3207LP2900XAnesthesiologyPain MedicineX
4207LP3000XAnesthesiologyPediatric AnesthesiologyX
5208600000XSurgeryX
6208VP0000XPain MedicinePain MedicineX
7367500000XNurse Anesthetist, Certified RegisteredX

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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