Provider Demographics
NPI:1396976924
Name:HTP-AMIC PAIN TREATMENT SURGICAL SUITES INC
Entity type:Organization
Organization Name:HTP-AMIC PAIN TREATMENT SURGICAL SUITES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:T
Authorized Official - Last Name:PYE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-308-4738
Mailing Address - Street 1:11600 S KEDZIE AVE
Mailing Address - Street 2:
Mailing Address - City:MERRIONETTE PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60803-6307
Mailing Address - Country:US
Mailing Address - Phone:773-238-5300
Mailing Address - Fax:773-442-0970
Practice Address - Street 1:11012 S WESTERN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60643-3928
Practice Address - Country:US
Practice Address - Phone:773-308-4738
Practice Address - Fax:773-442-0970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-30
Last Update Date:2009-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036093488261QP3300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL614276100OtherUNITED STATES DEPARTMENT OF LABOR