Organization
MIDWEST PAIN CENTERS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAY JOSHI M.D. (MEDICAL DIRECTOR)
(847) 701-5040
Entity
Organization
Contact information
Practice address
800 BIESTERFIELD RD, STE. 302, ELK GROVE VILLAGE, IL 60007-3361
(847) 701-5040
Mailing address
21720 W LONG GROVE RD, STE. C200, DEER PARK, IL 60010-3732
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
036115091
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
131846500
DEPARTMENT OF LABOR
IL
01
—
1619628
BCBS PROVIDER
IL
01
—
K28133
MEDICARE ID-LOCALITY 16 PIN
IL
01
—
K28134
MEDICARE ID-LOCALITY 15 PIN
IL
01
—
P00349345
MEDICARE ID-RAILROAD MEDICARE
IL
Enumeration date
09/14/2010
Last updated
01/11/2011
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