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General NPI Number Information
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NPI Number | 1043322001
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Entity Type | Organization
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Legal Business Name | JOLIET PAIN CARE CENTER
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 2121 ONEIDA ST #304
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City | JOLIET
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State | IL
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Zip | 60435
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Country | US
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Telephone | 815-730-6800
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Fax | 815-730-6868
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Provider Business Mailing Address
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Address Line | 8255 LEMONT RD STE 200
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City | DARIEN
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State | IL
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Zip | 60561-1800
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Country | US
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Telephone | 630-598-2624
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Fax | 630-598-2674
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | SCOTT RICHARD ANDERSON
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Credential |
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Telephone | 630-598-2600
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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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Taxonomy #2
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Taxonomy Code | 2084P2900X
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Taxonomy Name | Pain Medicine (Psychiatry & Neurology) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 2084S0012X
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Taxonomy Name | Sleep Medicine (Psychiatry & Neurology) Physician
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License Number |
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License Number State |
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