Chicago Pain Medicine Center

LBN: Chicago Pain Medicine Center
Chicago Pain Medicine Center is an health care organization with primary practice located at 8012 S Crandon Ave , Chicago IL 60617-1124. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Interventional Pain Medicine, Suppliers / Durable Medical Equipment & Medical Supplies. Allopathic & Osteopathic Physicians / Interventional Pain Medicine is the primary health care specialty. Chicago Pain Medicine Center can be contacted via phone (773) 868-6824, or through Diesfeld, James R via phone (773) 868-6824.

Contact Information

Primary practice address
8012 S Crandon Ave Chicago IL 60617-1124
Phone: (773) 868-6824
Fax: (773) 868-6828
Website:
Map and Directions
Authorized official contact:
Name: Diesfeld, James R Doctor of Medicine (MD)
Phone: (773) 868-6824

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Interventional Pain Medicine 208VP0014X
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X

Profile Details

NPI number 1871190827
LBN Legal business name Chicago Pain Medicine Center
DBA Doing business as
Authorized official Diesfeld, James R Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Oct 2nd, 2020
Last updated Oct 2nd, 2020 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871190827 NPPES
Illinois MEDICAID 036086023

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