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Organization
PAIN MANAGEMENT SERVICES MIDWEST, LTD.
Active
Organization
PAIN MANAGEMENT SERVICES MIDWEST, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MALCOLM HERZOG DPM (PRESIDENT)
(773) 284-6401
Entity
Organization
Contact information
Practice address
5241 S CICERO AVE, CHICAGO, IL 60632-4967
(773) 284-6401
(773) 582-2126
Mailing address
PO BOX 388387, CHICAGO, IL 60638-8387
(773) 284-6401
(773) 582-2126
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
NULL
111N00000X
Chiropractor
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
IL
Other
Enumeration date
01/29/2008
Last updated
11/24/2008
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