Provider Demographics
NPI:1184939548
Name:PAINLESS MEDICAL PRACTICE LTD
Entity type:Organization
Organization Name:PAINLESS MEDICAL PRACTICE LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAROSLAV
Authorized Official - Middle Name:
Authorized Official - Last Name:TYMOUCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-697-7946
Mailing Address - Street 1:2515 W CHICAGO AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622-4516
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2515 W CHICAGO AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-4516
Practice Address - Country:US
Practice Address - Phone:773-697-7946
Practice Address - Fax:312-864-9542
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-10
Last Update Date:2016-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036116592207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty