Organization
CHICAGO PAIN MEDICINE CENTER
Active
Organization
CHICAGO PAIN MEDICINE CENTER
Active
Parent organization
CHICAGO PAIN MEDICINE CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
CHICAGO PAIN MEDICINE CENTER
Authorized official
JAMES R DIESFELD (PRESIDENT)
(773) 868-6824
Entity
Organization
Contact information
Practice address
5215 N CALIFORNIA AVE STE F717, CHICAGO, IL 60625-8562
(773) 868-6824
Mailing address
1044 N FRANCISCO AVE, CHICAGO, IL 60622-2743
(773) 868-6824
(773) 868-6828
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036086023
—
IL
Enumeration date
10/24/2018
Last updated
07/09/2020
Update your record
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