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Organization
VALLEY PAIN CARE CENTERS LTD
Active
Organization
VALLEY PAIN CARE CENTERS LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL COULSON D.O. (OWNER)
(815) 749-8993
Entity
Organization
Contact information
Practice address
1 KISH HOSPITAL DR, DEKALB, IL 60115-9602
(815) 766-1258
(708) 469-6614
Mailing address
1879 N NELTNOR BLVD # 224, WEST CHICAGO, IL 60185-5932
(815) 766-1258
(630) 343-5372
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001930204
BCBS GROUP #
IL
01
—
CH9839
RAILROAD MEDICARE
IL
Enumeration date
07/06/2005
Last updated
01/10/2025
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