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PAIN & SPINE INSTITUTE LLC NPI 1578610176


NPI Information

NPI: 1578610176
Provider Name: PAIN & SPINE INSTITUTE, LLC
Classification: Anesthesiology - 207LP2900X
Entity Type: Organization

Specialization: Pain Medicine

CLIA Number: 14D2300296

Address:
744 ESSINGTON RD
JOLIET, IL
ZIP 60435
Phone: (815) 729-0700
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PAIN & SPINE INSTITUTE, LLC is a pain medicine anesthesiology in Joliet, IL. The provider is an anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. PAIN & SPINE INSTITUTE, LLC NPI is 1578610176. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

744 ESSINGTON RD
JOLIET, IL
ZIP 60435-912
Phone: (815) 729-0700
Fax: (815) 729-0707

The provider's authorized official is Samir Sharma .
The authorized official title is Member and has the following contact phone number (312) 961-2045.

The CLIA number assigned to this NPI record is 14D2300296 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/4/2007 and was last updated on 12/5/2022.


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
1207LP2900XAnesthesiologyPain Medicine36-113508ILLINOISYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1036116060MEDICAIDILLINOIS
209932517OTHERILLINOISBLUE CROSS BLUE SHIELD
3036113508MEDICAIDILLINOIS

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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