Provider Demographics
NPI:1457387078
Name:ADVANCED PAIN AND ANESTHESIA CONSULTANTS, PC
Entity Type:Organization
Organization Name:ADVANCED PAIN AND ANESTHESIA CONSULTANTS, PC
Other - Org Name:APAC, PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:FAISAL
Authorized Official - Middle Name:M
Authorized Official - Last Name:RAHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:219-488-0176
Mailing Address - Street 1:11456 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:CROWN POINT
Mailing Address - State:IN
Mailing Address - Zip Code:46307-7106
Mailing Address - Country:US
Mailing Address - Phone:219-488-0156
Mailing Address - Fax:219-661-1408
Practice Address - Street 1:11456 BROADWAY
Practice Address - Street 2:
Practice Address - City:CROWN POINT
Practice Address - State:IN
Practice Address - Zip Code:46307-7106
Practice Address - Country:US
Practice Address - Phone:219-488-0176
Practice Address - Fax:219-661-1408
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-24
Last Update Date:2014-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01628028OtherBCBSIL
INCG3000Medicare ID - Type UnspecifiedRRMEDICARE
IL01628028OtherBCBSIL
IN141980Medicare ID - Type UnspecifiedGROUP NUMBER
IL201133Medicare ID - Type UnspecifiedKANE COUNTY