Organization
SUBURBAN PAIN CARE SURGICAL FACILITY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELTON WADE DIXON M.D. (PHYSICIAN/OWNER)
(630) 810-0451
Entity
Organization
Contact information
Practice address
18425 W CREEK DR, STE B, TINLEY PARK, IL 60477-6767
(630) 810-0451
(877) 446-3870
Mailing address
73 W 61ST ST, WESTMONT, IL 60559-2615
(630) 810-0451
(877) 446-3870
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
09/24/2008
Last updated
09/24/2008
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