Organization
PAIN SPECIALISTS OF GREATER CHICAGO SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNE GLASER (CONTROLLER)
(630) 371-9980
Entity
Organization
Contact information
Practice address
7055 HIGH GROVE BLVD, BURR RIDGE, IL 60527-7593
(630) 371-9980
(630) 371-9983
Mailing address
7055 HIGH GROVE BLVD, BURR RIDGE, IL 60527-7593
(630) 371-9980
(630) 371-9983
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
036082680
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036078362
BLUE CROSS
IL
Enumeration date
07/27/2006
Last updated
10/08/2014
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