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Organization
PAIN CENTERS OF CHICAGO LLC
Active
Organization
PAIN CENTERS OF CHICAGO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH BERNOCCO (PROVIDER ENROLLMENT TEAM LEAD)
(516) 945-3163
Entity
Organization
Contact information
Practice address
5666 E STATE ST, ROCKFORD, IL 61108-2425
(815) 729-0450
Mailing address
1305 WALT WHITMAN RD STE 300, MELVILLE, NY 11747-4300
(516) 945-3000
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
208VP0000X
Pain Medicine Physician
Primary
—
—
Other
Enumeration date
02/03/2021
Last updated
03/15/2023
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