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General NPI Number Information
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NPI Number | 1629481940
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Entity Type | Organization
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Legal Business Name | UNITED PAIN CONSULTANTS LLC
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Dates
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Enumeration Date | 06/04/2014
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Last Update Date | 06/04/2014
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Provider Practice Location Address
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Address Line | 6323 N AVONDALE AVE SUITE B-101
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City | CHICAGO
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State | IL
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Zip | 60631-1962
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Country | US
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Telephone | 773-512-3947
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Fax |
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Provider Business Mailing Address
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Address Line | 1707 W SURF ST
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City | CHICAGO
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State | IL
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Zip | 60657-6198
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Country | US
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Telephone | 773-512-3947
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | NAVEEN TIPIRNENI
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Credential | M.D.
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Telephone | 773-512-3947
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | 036118887
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License Number State | IL
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