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General NPI Number Information
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NPI Number | 1043161060
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Entity Type | Organization
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Legal Business Name | MODERN PAIN MANAGEMENT
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Dates
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Enumeration Date | 02/05/2026
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Last Update Date | 02/05/2026
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Provider Practice Location Address
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Address Line | 1795 N BUTTERFIELD RD STE 108
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City | LIBERTYVILLE
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State | IL
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Zip | 60048-1212
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Country | US
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Telephone | 773-818-1544
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Fax |
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Provider Business Mailing Address
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Address Line | 1795 N BUTTERFIELD RD STE 108
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City | LIBERTYVILLE
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State | IL
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Zip | 60048-1212
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Country | US
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Telephone | 773-818-1544
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Fax |
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Authorized Official
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Title or Position | MD
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Name | MARIAM EL-BAGHDADI
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Credential |
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Telephone | 504-905-9425
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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