Healthcare Provider Details

I. General information

NPI: 1912019977
Provider Name (Legal Business Name): PAIN CARE AMERICA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8255 LEMONT RD STE 200
DARIEN IL
60561-1800
US

IV. Provider business mailing address

8255 LEMONT RD STE 200
DARIEN IL
60561-1800
US

V. Phone/Fax

Practice location:
  • Phone: 630-598-2624
  • Fax: 630-598-2674
Mailing address:
  • Phone: 630-598-2624
  • Fax: 630-598-2674

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State

VIII. Authorized Official

Name: SCOTT RICHARD ANDERSON
Title or Position: CHIEF EXECUTIVE OFFICER ADMINISTRAT
Credential:
Phone: 630-598-2600