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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
MATTHEW WALSH MD (AUTHORIZED OFFICIAL)
(516) 945-3000
Entity
Organization
Contact information
Practice address
1305 WALT WHITMAN RD STE 300, MELVILLE, NY 11747-4300
(516) 945-3000
(815) 729-0459
Mailing address
PO BOX 305, BEDFORD PARK, IL 60499
(815) 729-0450
(815) 729-0459
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
NULL
174400000X
Specialist
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
NULL
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
208VP0000X
Pain Medicine Physician
Primary
—
NULL
208VP0000X
Pain Medicine Physician
Primary
—
—
Other
Enumeration date
12/01/2006
Last updated
03/15/2023
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