Organization
PAIN CARE CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASMINE MALY MD (PRESIDENT)
(800) 444-6110
Entity
Organization
Contact information
Practice address
350 N WALL STREET, KANKAKEE, IL 60901
(815) 936-7246
Mailing address
PO BOX 623, BOURBONNAIS, IL 60914-0623
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
36101753
IL
Other
Enumeration date
06/16/2006
Last updated
10/29/2007
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