Provider Demographics
NPI:1629354113
Name:DR M ESTILO PAIN MANAGEMENT LLC
Entity Type:Organization
Organization Name:DR M ESTILO PAIN MANAGEMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA PILAR
Authorized Official - Middle Name:
Authorized Official - Last Name:ESTILO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:815-941-1522
Mailing Address - Street 1:1802 N DIVISION ST
Mailing Address - Street 2:SUITE 704
Mailing Address - City:MORRIS
Mailing Address - State:IL
Mailing Address - Zip Code:60450-1182
Mailing Address - Country:US
Mailing Address - Phone:815-941-1522
Mailing Address - Fax:815-941-1523
Practice Address - Street 1:603 W MONDAMIN ST
Practice Address - Street 2:
Practice Address - City:MINOOKA
Practice Address - State:IL
Practice Address - Zip Code:60447-9057
Practice Address - Country:US
Practice Address - Phone:815-941-1522
Practice Address - Fax:815-941-1523
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-27
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036100822207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty