Provider Demographics
NPI:1760904635
Name:CHICAGO PAIN AND SPINE LLC
Entity Type:Organization
Organization Name:CHICAGO PAIN AND SPINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:NAVEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:TIPIRNENI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-512-3947
Mailing Address - Street 1:1716 W WELLINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-4028
Mailing Address - Country:US
Mailing Address - Phone:773-512-3947
Mailing Address - Fax:773-637-4229
Practice Address - Street 1:2333 N HARLEM AVE STE 100
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60707-2718
Practice Address - Country:US
Practice Address - Phone:773-637-2333
Practice Address - Fax:773-637-4229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-12
Last Update Date:2017-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain