Provider Demographics
NPI:1760491450
Name:PAIN CARE SPECIALISTS, LLC
Entity Type:Organization
Organization Name:PAIN CARE SPECIALISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NEERAJ
Authorized Official - Middle Name:
Authorized Official - Last Name:JAIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-787-2998
Mailing Address - Street 1:LBX 809115
Mailing Address - Street 2:PO BOX 809115
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60680-9115
Mailing Address - Country:US
Mailing Address - Phone:312-787-2998
Mailing Address - Fax:312-787-7295
Practice Address - Street 1:908 N ELM ST
Practice Address - Street 2:SUITE 109
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521
Practice Address - Country:US
Practice Address - Phone:630-794-9999
Practice Address - Fax:630-794-9998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL211393Medicare ID - Type UnspecifiedCOOK
IL209991Medicare ID - Type UnspecifiedDUPAGE