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General NPI Number Information
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NPI Number | 1164567236
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Entity Type | Organization
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Legal Business Name | ADVANCED PAIN CONSULTANTS, S.C.
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Dates
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Enumeration Date | 02/20/2007
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Last Update Date | 03/24/2025
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Provider Practice Location Address
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Address Line | 2100 CLEARWATER DR STE 100
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City | OAK BROOK
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State | IL
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Zip | 60523-1931
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Country | US
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Telephone | 630-607-1000
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Fax | 630-607-1002
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Provider Business Mailing Address
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Address Line | 2100 CLEARWATER DR STE 100
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City | OAK BROOK
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State | IL
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Zip | 60523-1931
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Country | US
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Telephone | 630-607-1000
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Fax | 630-607-1002
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Authorized Official
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Title or Position | PRESIDENT & CEO
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Name | NICHOLAS KONDELIS
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Credential | MD
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Telephone | 630-607-1000
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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 | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number |
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License Number State |
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