Organization
PREMIERCARE ANESTHESIA & PAIN P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL MAKSIMOVICH M.D. (PRESIDENT)
(630) 400-4881
Entity
Organization
Contact information
Practice address
3407 W FULLERTON AVE, CHICAGO, IL 60647-2497
(312) 475-1203
(312) 929-3739
Mailing address
200 W MENOMONEE ST, UNIT 4, CHICAGO, IL 60614-5313
(630) 400-4881
(312) 929-3739
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
036.087570
IL
207LP2900X
Pain Medicine (Anesthesiology) Physician
036.087570
IL
Other
Enumeration date
03/09/2014
Last updated
01/13/2016
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