Healthcare Provider Details

I. General information

NPI: 1790912434
Provider Name (Legal Business Name): PINNACLE PAIN MANAGEMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2009
Last Update Date: 05/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

908 N ELM ST 109
HINSDALE IL
60521-3635
US

IV. Provider business mailing address

908 N ELM ST 109
HINSDALE IL
60521-3635
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License Number036082067
License Number StateIL

VIII. Authorized Official

Name: DR. NEERAJ JAIN
Title or Position: OWNER
Credential: M.D.
Phone: 630-794-9999