Organization
N R ANESTHESIA & PAIN MANAGEMENT S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NASER RUSTOM (PRESIDENT)
(773) 237-2900
Entity
Organization
Contact information
Practice address
4849 W FULLERTON AVE, CHICAGO, IL 60639-2503
(773) 237-2900
(773) 622-0769
Mailing address
4849 W FULLERTON AVE, CHICAGO, IL 60639-2503
(773) 237-2900
(773) 622-0769
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
261QA1903X
Ambulatory Surgical Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1636026
BCBS OF IL PROVIDER #
IL
Enumeration date
06/09/2006
Last updated
01/08/2024
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