Provider Demographics
NPI:1821486861
Name:KALINA PAIN INSTITUTE
Entity Type:Organization
Organization Name:KALINA PAIN INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JARED
Authorized Official - Middle Name:A
Authorized Official - Last Name:KALINA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:773-899-2261
Mailing Address - Street 1:625 S OAK PARK AVE
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60304-1213
Mailing Address - Country:US
Mailing Address - Phone:773-899-2261
Mailing Address - Fax:
Practice Address - Street 1:334 CIRCLE AVE
Practice Address - Street 2:
Practice Address - City:FOREST PARK
Practice Address - State:IL
Practice Address - Zip Code:60130-1610
Practice Address - Country:US
Practice Address - Phone:708-628-8574
Practice Address - Fax:866-282-9069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-29
Last Update Date:2018-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036119113208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty