Organization
ILLINOIS PAIN SPECIALISTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BOJAN PAVLOVIC MD (PRESIDENT)
(773) 307-3009
Entity
Organization
Contact information
Practice address
1790 NATIONS DR, SUITE 111, GURNEE, IL 60031-9164
(773) 307-3009
Mailing address
601 WASHINGTON AVE, 390, NEWPORT, KY 41071-1986
(859) 291-4800
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
036.115520
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4301089505
LICENSE NUMBER
IL
Enumeration date
08/16/2010
Last updated
08/16/2010
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