Organization
PAIN CENTERS OF CHICAGO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH BERNOCCO (PROVIDER ENROLLMENT TEAM LEAD)
(516) 945-3163
Entity
Organization
Contact information
Practice address
5666 E STATE ST, ROCKFORD, IL 61108-2425
(815) 729-0450
Mailing address
1305 WALT WHITMAN RD STE 300, MELVILLE, NY 11747-4300
(516) 945-3000
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
208VP0000X
Pain Medicine Physician
Primary
—
—
Other
Enumeration date
02/03/2021
Last updated
03/15/2023
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