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General NPI Number Information
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NPI Number | 1396976924
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Entity Type | Organization
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Legal Business Name | HTP-AMIC PAIN TREATMENT SURGICAL SUITES INC
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Dates
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Enumeration Date | 07/30/2009
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Last Update Date | 07/30/2009
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Provider Practice Location Address
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Address Line | 11012 S WESTERN AVE
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City | CHICAGO
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State | IL
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Zip | 60643-3928
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Country | US
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Telephone | 773-308-4738
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Fax | 773-442-0970
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Provider Business Mailing Address
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Address Line | 11600 S KEDZIE AVE
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City | MERRIONETTE PARK
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State | IL
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Zip | 60803-6307
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Country | US
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Telephone | 773-238-5300
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Fax | 773-442-0970
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Authorized Official
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Title or Position | PHYSICIAN/CEO
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Name | DR. HAROLD T PYE
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Credential | MD
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Telephone | 773-308-4738
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number | 036093488
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License Number State | IL
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