# PAIN MANAGEMENT SERVICES MIDWEST, LTD.

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

## Provider details

- **NPI number:** 1649457920
- **Authorized official:** DR. MALCOLM HERZOG DPM (PRESIDENT)
- **Authorized official phone:** (773) 284-6401

## Contact information

- **Practice address:** 5241 S CICERO AVE, CHICAGO, IL 60632-4967
- **Practice address phone:** (773) 284-6401
- **Practice address fax:** (773) 582-2126
- **Mailing address:** PO BOX 388387, CHICAGO, IL 60638-8387
- **Mailing address phone:** (773) 284-6401
- **Mailing address fax:** (773) 582-2126

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | — | NULL | — |
| 111N00000X | Chiropractor | — | — | — |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | IL | Yes |

## Other

- **Enumeration date:** 01/29/2008
- **Last updated:** 11/24/2008