Provider Demographics
NPI:1922030790
Name:ASSOCIATES IN PAIN MANAGEMENT, INC
Entity Type:Organization
Organization Name:ASSOCIATES IN PAIN MANAGEMENT, INC
Other - Org Name:ASSOCIATES IN PAIN MANAGEMENT, INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:YULIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:KIN-KARTSIMAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-224-6585
Mailing Address - Street 1:6 E PHILLIP RD
Mailing Address - Street 2:SUITE 1106
Mailing Address - City:VERNON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60061-1700
Mailing Address - Country:US
Mailing Address - Phone:847-968-5955
Mailing Address - Fax:847-968-5975
Practice Address - Street 1:6 E PHILLIP RD
Practice Address - Street 2:SUITE 1106
Practice Address - City:VERNON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60061-1700
Practice Address - Country:US
Practice Address - Phone:847-968-5955
Practice Address - Fax:847-968-5975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036108397174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL4932554OtherBCBS
IL213758Medicare PIN
IL4932554OtherBCBS