Organization
MIDWEST SPORTS MEDICINE & ORTHOPEDIC SURGICAL SPECIALISTS
Active
Other names
The Center for Pain Management
Organization subpart
No
Provider details
NPI number
Authorized official
ROSEMARY A MARTIN (DIRECTOR)
(847) 437-9889
Entity
Organization
Contact information
Practice address
901 BIESTERFIELD RD, SUITE 101, ELK GROVE VILLAGE, IL 60007-3392
(847) 437-9889
Mailing address
901 BIESTERFIELD RD, SUITE 101, ELK GROVE VILLAGE, IL 60007-3392
(847) 437-9889
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31603457
BLUE CROSS BLUE SHIELD
IL
Enumeration date
05/22/2007
Last updated
08/22/2020
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