Provider Demographics
NPI:1558433854
Name:CHICAGO MEDICAL & PAIN ASSOC LTD
Entity Type:Organization
Organization Name:CHICAGO MEDICAL & PAIN ASSOC LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:IAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:BELTON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:760-271-6872
Mailing Address - Street 1:630 N FRANKLIN ST
Mailing Address - Street 2:SUITE 801
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60610-8327
Mailing Address - Country:US
Mailing Address - Phone:773-358-8600
Mailing Address - Fax:773-585-5980
Practice Address - Street 1:3535 W FULLERTON AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60647-2417
Practice Address - Country:US
Practice Address - Phone:773-227-1717
Practice Address - Fax:773-227-0202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038010386111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty