Healthcare Provider Details
I. General information
NPI: 1851404131
Provider Name (Legal Business Name): RX PAIN MANAGEMENT
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/17/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
736 W 35TH ST
CHICAGO IL
60616-4484
US
IV. Provider business mailing address
229 W 25TH PL
CHICAGO IL
60616-2220
US
V. Phone/Fax
- Phone: 773-247-2131
- Fax: 773-247-3110
- Phone: 773-247-2131
- Fax: 773-247-3110
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | IL |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | |
| License Number State | IL |
VIII. Authorized Official
Name: DR.
DALMACIO
CUSI
Title or Position: PHYSICIAN
Credential: MD
Phone: 773-247-2131