Provider Demographics
NPI:1437244647
Name:COMPLETE PAIN MANAGEMENT LLC
Entity Type:Organization
Organization Name:COMPLETE PAIN MANAGEMENT LLC
Other - Org Name:COMPLETE PAIN MANAGEMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:H
Authorized Official - Last Name:GRUFT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-920-0015
Mailing Address - Street 1:1 TRANSAM PLAZA DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:OAKBROOK TERRACE
Mailing Address - State:IL
Mailing Address - Zip Code:60181-4822
Mailing Address - Country:US
Mailing Address - Phone:630-627-7500
Mailing Address - Fax:630-627-7502
Practice Address - Street 1:1 TRANSAM PLAZA DR
Practice Address - Street 2:SUITE 100
Practice Address - City:OAKBROOK TERRACE
Practice Address - State:IL
Practice Address - Zip Code:60181-4822
Practice Address - Country:US
Practice Address - Phone:630-627-7500
Practice Address - Fax:630-627-7502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2009-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070010605225100000X
IL070002880225100000X
IL036080153225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation PractitionerGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========OtherTAX ID
IL207631Medicare UPIN
IL207733Medicare UPIN
ILE44095Medicare UPIN