Provider Demographics
NPI:1942354238
Name:CHICAGO PAIN CLINICS, LLC
Entity Type:Organization
Organization Name:CHICAGO PAIN CLINICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:HOSSEINIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-281-0744
Mailing Address - Street 1:5415 N SHERIDAN RD
Mailing Address - Street 2:APT 2202
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-1954
Mailing Address - Country:US
Mailing Address - Phone:847-337-6790
Mailing Address - Fax:847-337-6790
Practice Address - Street 1:2425 W 22ND ST
Practice Address - Street 2:#101
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-1245
Practice Address - Country:US
Practice Address - Phone:630-990-2212
Practice Address - Fax:630-990-3130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty