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
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