Healthcare Provider Details
I. General information
NPI: 1497884159
Provider Name (Legal Business Name): ELGIN PAIN & HEADACHE CENTER, S.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/05/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1975 LIN LOR LN SUITE 175
ELGIN IL
60123-4902
US
IV. Provider business mailing address
185 PENNY AVE
EAST DUNDEE IL
60118-1454
US
V. Phone/Fax
- Phone: 847-717-4790
- Fax:
- Phone: 847-836-7015
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | |
| License Number State | IL |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208VP0014X |
| Taxonomy | Interventional Pain Medicine Physician |
| License Number | |
| License Number State | IL |
VIII. Authorized Official
Name: DR.
J. NNAEMEKA
ONWUTA
Title or Position: PRESIDENT
Credential: M.D.
Phone: 847-717-4790