MEDICARE: MIDWEST PHYSICAN PAIN CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208VP0000X	Pain Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871522631
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIDWEST PHYSICAN PAIN CENTER

Provider Business Mailing Address
First Line	:	8 CASCADE CT W
Second Line	:
City	:	BURR RIDGE
State	:	IL
Zip	:	60527-0715
Country	:	US
Telephone Number	:	630-887-1482
Fax Number	:	773-933-4903

Provider Business Practice Location Address
First Line	:	3522 E 95TH ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60617-5164
Country	:	US
Telephone Number	:	630-202-2230
Fax Number	:	773-933-4903

Authorized Official
Title or Position	:	OWNER
Name	:	RANJIT SINGH WAHI
Credential	:	MD
Telephone Number	:	773-933-0791

Provider Enumeration Date	:	07/02/2006
Last Update Date	:	09/29/2023

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Directions to “MIDWEST PHYSICAN PAIN CENTER ” Practice Location

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