Provider Demographics
NPI:1295811479
Name:ILLINOIS PAIN TREATMENT INSTITUTE, LTD
Entity type:Organization
Organization Name:ILLINOIS PAIN TREATMENT INSTITUTE, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHADI
Authorized Official - Middle Name:ISKANDAR
Authorized Official - Last Name:YAACOUB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-289-8822
Mailing Address - Street 1:431 SUMMIT
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60120
Mailing Address - Country:US
Mailing Address - Phone:847-289-8822
Mailing Address - Fax:847-289-0815
Practice Address - Street 1:431 SUMMIT
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60120
Practice Address - Country:US
Practice Address - Phone:847-289-8822
Practice Address - Fax:847-289-0815
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-31
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILCM 4844OtherRAILROAD MEDICARE
ILDA 3105OtherRAILROAD MEDICARE
1619144OtherBC
ILCA 2780OtherRAILROAD MEDICARE
990851Medicare ID - Type Unspecified
ILCA 2780OtherRAILROAD MEDICARE
IL990852Medicare ID - Type Unspecified