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General NPI Number Information
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NPI Number | 1033427950
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Entity Type | Organization
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Legal Business Name | MIDWEST PAIN CENTERS, INC.
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Dates
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Enumeration Date | 09/14/2010
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Last Update Date | 01/11/2011
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Provider Practice Location Address
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Address Line | 800 BIESTERFIELD RD STE. 302
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City | ELK GROVE VILLAGE
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State | IL
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Zip | 60007-3361
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Country | US
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Telephone | 847-701-5040
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Fax |
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Provider Business Mailing Address
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Address Line | 21720 W LONG GROVE RD STE. C200
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City | DEER PARK
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State | IL
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Zip | 60010-3732
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | JAY JOSHI
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Credential | M.D.
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Telephone | 847-701-5040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | 036115091
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License Number State | IL
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