# THE PAIN CENTER OF ILLINOIS INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053588079
- **Authorized official:** NEEMA BAYRAN MD (C.E.O.)
- **Authorized official phone:** (312) 593-1580

## Contact information

- **Practice address:** 2041 W DIVISION ST, CHICAGO, IL 60622-8521
- **Practice address phone:** (312) 624-8364
- **Practice address fax:** (312) 929-3323
- **Mailing address:** 2041 W DIVISION ST, CHICAGO, IL 60622-8521
- **Mailing address phone:** (312) 624-8364

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | 036-103729 | IL | — |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/08/2008
- **Last updated:** 09/24/2024