Healthcare Provider Details

I. General information

NPI: 1023044146
Provider Name (Legal Business Name): ADVANCED PAIN CENTERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2006
Last Update Date: 12/06/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5355 COMMERCE DR
CROWN POINT IN
46307-5325
US

IV. Provider business mailing address

13 W US HIGHWAY 30 SUITE 202
SCHERERVILLE IN
46375-2266
US

V. Phone/Fax

Practice location:
  • Phone: 219-756-0600
  • Fax:
Mailing address:
  • Phone: 219-865-3819
  • Fax: 219-865-5401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. FAISAL M. RAHMAN
Title or Position: CEO
Credential: PH.D.
Phone: 219-865-3819