Organization
MIDWEST PAIN SPECIALISTS SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYNNETTE MCROY (BILLING COORDINATOR)
(773) 767-3822
Entity
Organization
Contact information
Practice address
3139 W 111TH ST, CHICAGO, IL 60655-2205
(312) 208-4492
(773) 337-9106
Mailing address
3139 W 111TH ST, CHICAGO, IL 60655-2205
(312) 208-4492
(773) 337-9106
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
036082067
IL
Other
Enumeration date
09/21/2015
Last updated
09/21/2015
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