# PREMIERCARE ANESTHESIA & PAIN P.C.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1649696147
- **Authorized official:** DR. DANIEL MAKSIMOVICH M.D. (PRESIDENT)
- **Authorized official phone:** (630) 400-4881

## Contact information

- **Practice address:** 3407 W FULLERTON AVE, CHICAGO, IL 60647-2497
- **Practice address phone:** (312) 475-1203
- **Practice address fax:** (312) 929-3739
- **Mailing address:** 200 W MENOMONEE ST, UNIT 4, CHICAGO, IL 60614-5313
- **Mailing address phone:** (630) 400-4881
- **Mailing address fax:** (312) 929-3739

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | 036.087570 | IL | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | 036.087570 | IL | — |

## Other

- **Enumeration date:** 03/09/2014
- **Last updated:** 01/13/2016