# BROOKSIDE ADVANCED CLINIC FOR PAIN,INC.

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

## Provider details

- **NPI number:** 1730326687
- **Authorized official:** MR. DANIEL W BORVAN (PRESIDENT)
- **Authorized official phone:** (815) 469-9750

## Contact information

- **Practice address:** 21120 WASHINGTON PKWY, FRANKFORT, IL 60423-3112
- **Practice address phone:** (815) 469-9750
- **Practice address fax:** (815) 469-9752
- **Mailing address:** 21120 WASHINGTON PKWY, FRANKFORT, IL 60423-3112
- **Mailing address phone:** (815) 469-9750
- **Mailing address fax:** (815) 469-9752

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | 209003563 | IL | Yes |

## Other

- **Enumeration date:** 01/14/2009
- **Last updated:** 01/14/2009