Healthcare Provider Details

I. General information

NPI: 1962401745
Provider Name (Legal Business Name): MIDWEST PAIN MANAGEMENT CENTERS,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2005
Last Update Date: 02/25/2026
Certification Date: 02/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8840 CALUMET AVE STE 103
MUNSTER IN
46321-2546
US

IV. Provider business mailing address

7951 SHOAL CREEK BLVD STE 300
AUSTIN TX
78757-7582
US

V. Phone/Fax

Practice location:
  • Phone: 219-836-7246
  • Fax: 219-836-6454
Mailing address:
  • Phone: 512-584-8404
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number StateIN

VIII. Authorized Official

Name: SANDFORD MATTHEW SCHOCKET
Title or Position: CEO
Credential: MD
Phone: 512-584-8404