Organization
SUBURBAN PAINCARE CENTER P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELTON WADE DIXON M.D. (OWNER/PHYSICIAN)
(630) 810-0451
Entity
Organization
Contact information
Practice address
535 S WASHINGTON ST, STE 22, NAPERVILLE, IL 60540-6795
(630) 810-0451
(877) 446-3870
Mailing address
18660 GRAPHIC DR, STE 100, TINLEY PARK, IL 60477-6260
(630) 810-0451
(877) 446-3870
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
—
—
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
—
2084P2900X
Pain Medicine (Psychiatry & Neurology) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1633419
BCBS PROVIDER NUMBER
IL
Enumeration date
08/31/2006
Last updated
09/05/2014
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