Healthcare Provider Details

I. General information

NPI: 1386660033
Provider Name (Legal Business Name): CPMG MA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 06/11/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2750 S RIVER RD
DES PLAINES IL
60018-4103
US

IV. Provider business mailing address

3300 GREENBRIAR LN
RIVERWOODS IL
60015-3857
US

V. Phone/Fax

Practice location:
  • Phone: 847-470-8740
  • Fax: 847-470-8750
Mailing address:
  • Phone: 847-470-8740
  • Fax: 847-470-8750

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: HOWARD S KONOWITZ
Title or Position: MANAGING PARTNER
Credential: MD
Phone: 847-921-9733