Healthcare Provider Details

I. General information

NPI: 1932496726
Provider Name (Legal Business Name): PINNACLE PAIN MANAGEMENT SPECIALISTS SC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2011
Last Update Date: 08/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

908 N ELM ST SUITE 301
HINSDALE IL
60521
US

IV. Provider business mailing address

908 N ELM ST SUITE 301
HINSDALE IL
60521-3635
US

V. Phone/Fax

Practice location:
  • Phone: 630-794-9999
  • Fax: 630-794-9998
Mailing address:
  • Phone: 630-794-9999
  • Fax: 630-794-9998

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License Number
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. NEERAJ JAIN
Title or Position: DIRECTOR
Credential: MD
Phone: 630-794-9999