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General NPI Number Information
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NPI Number | 1609169945
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Entity Type | Organization
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Legal Business Name | ILLINOIS ANESTHESIA AND PAIN ASSOCIATES SC
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Dates
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Enumeration Date | 05/19/2011
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Last Update Date | 08/09/2011
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Provider Practice Location Address
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Address Line | 11634 QUARTZ CT
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City | FRANKFORT
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State | IL
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Zip | 60423-9028
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Country | US
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Telephone | 708-479-6522
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Fax | 708-286-6461
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Provider Business Mailing Address
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Address Line | 1301 COPPERFIELD AVE STE 206
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City | JOLIET
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State | IL
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Zip | 60432-2056
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Country | US
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Telephone | 708-479-6522
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Fax | 708-286-6461
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. YASSER HUSSEIN
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Credential | MD
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Telephone | 815-726-2368
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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 | 036100713
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License Number State | IL
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