PAIN CARE SURGERY PC NPI 1184690570

NPI Information

NPI: 1184690570
Provider Name: PAIN CARE SURGERY, PC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

Address:
108 AIRWAY DR
MARION, IL
ZIP 62959
Phone: (618) 997-7820
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PAIN CARE SURGERY, PC is an ambulatory surgical clinic center in Marion, IL. PAIN CARE SURGERY, PC NPI is 1184690570. The provider is registered as an organization entity type.

The provider's business location address is:

108 AIRWAY DR
MARION, IL
ZIP 62959-841
Phone: (618) 997-7820
Fax: (618) 997-6721

The provider's authorized official is Laxmaiah Manchikanti .
The authorized official title is Medical Director and has the following contact phone number (618) 997-7820.

The enumeration date for this NPI number is 2/24/2006 and was last updated on 10/5/2011.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA1903X	Clinic/Center	Ambulatory Surgical	7002900	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	100812	OTHER	ILLINOIS	HEALTH ALLIANCE
2	BC#50386	OTHER	ILLINOIS	BLUE CROSS/BLUE SHIELD
3	211007	MEDICARE ID-TYPE UNSPECIFIED	ILLINOIS	MEDICAR
4	=========6295901	MEDICAID	ILLINOIS

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: 5/5/2024

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