Healthcare Provider Details

I. General information

NPI: 1659318186
Provider Name (Legal Business Name): PAIN CONTROL ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 03/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 DIXIE HWY
CHICAGO HEIGHTS IL
60411-1748
US

IV. Provider business mailing address

PO BOX 783
SCHERERVILLE IN
46375-0783
US

V. Phone/Fax

Practice location:
  • Phone: 219-577-5226
  • Fax: 219-934-9660
Mailing address:
  • Phone: 219-577-5226
  • Fax: 219-864-9595

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number StateIL

VIII. Authorized Official

Name: DR. RAJIVE K ADLAKA
Title or Position: MANAGING MEMBER
Credential: MD
Phone: 219-577-5226