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Organization
ELITE PAIN MANAGEMENT SC
Active
Organization
ELITE PAIN MANAGEMENT SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAURICIO ORBEGOZO MD (MEDICAL DIRECTOR/OWNER)
(708) 704-1065
Entity
Organization
Contact information
Practice address
12337 S ROUTE 59, SUITE 119, PLAINFIELD, IL 60585-4625
(844) 724-7246
Mailing address
6894 FIELDSTONE DR, BURR RIDGE, IL 60527-6967
(708) 704-1065
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
036097219
IL
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
036097219
IL
Other
Enumeration date
04/09/2014
Last updated
04/09/2014
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