Healthcare Provider Details

I. General information

NPI: 1265378012
Provider Name (Legal Business Name): NILES CARE CENTER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2026
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8565 W DEMPSTER ST
NILES IL
60714-1401
US

IV. Provider business mailing address

8565 W DEMPSTER ST
NILES IL
60714-1401
US

V. Phone/Fax

Practice location:
  • Phone: 847-299-7000
  • Fax:
Mailing address:
  • Phone: 847-299-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. PETER SLAVIN
Title or Position: PRESIDENT
Credential: DC
Phone: 847-299-7000