# GREAT LAKES PHYSIATRISTS PC

> 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:** 1811096548
- **Authorized official:** DR. FRANK S POLLINA MD (PRESIDENT)
- **Authorized official phone:** (586) 498-2400

## Contact information

- **Practice address:** 25311 LITTLE MACK AVE, SUITE B, ST CLAIR SHORES, MI 48081
- **Practice address phone:** (586) 498-2400
- **Practice address fax:** (586) 498-2800
- **Mailing address:** 8301 RELIABLE PKWY, CHICAGO, IL 60686-0083
- **Mailing address phone:** (586) 498-2400
- **Mailing address fax:** (586) 498-2800

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | — |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | 4301045967 | MI | Yes |
| 208VP0014X | Interventional Pain Medicine Physician | — | NULL | — |
| 208VP0014X | Interventional Pain Medicine Physician | — | — | — |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |

## Other

- **Enumeration date:** 09/21/2006
- **Last updated:** 09/14/2020