# PAIN CENTERS OF CHICAGO LLC

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

## Provider details

- **NPI number:** 1801964473
- **Authorized official:** MATTHEW WALSH MD (AUTHORIZED OFFICIAL)
- **Authorized official phone:** (516) 945-3000

## Contact information

- **Practice address:** 1305 WALT WHITMAN RD STE 300, MELVILLE, NY 11747-4300
- **Practice address phone:** (516) 945-3000
- **Practice address fax:** (815) 729-0459
- **Mailing address:** PO BOX 305, BEDFORD PARK, IL 60499
- **Mailing address phone:** (815) 729-0450
- **Mailing address fax:** (815) 729-0459

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | — | NULL | — |
| 174400000X | Specialist | — | — | — |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | — |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | — |
| 208VP0000X | Pain Medicine Physician | — | NULL | Yes |
| 208VP0000X | Pain Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/01/2006
- **Last updated:** 03/15/2023