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NPI 1639050404

NPI 1639050404 : PAIN & SPINE INSTITUTE SURGERY CENTER : JOLIET, IL

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General NPI Number Information
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    NPI Number           |    1639050404
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    Entity Type          |    Organization 
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    Legal Business Name  |    PAIN & SPINE INSTITUTE SURGERY CENTER 
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Dates
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    Enumeration Date     |    09/09/2025
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    Last Update Date     |    09/09/2025
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Provider Practice Location Address
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    Address Line         |    756 ESSINGTON RD 
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    City                 |    JOLIET
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    State                |    IL
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    Zip                  |    60435-4912
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    Country              |    US
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    Telephone            |    815-729-0700
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    Fax                  |    815-729-0700
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Provider Business Mailing Address
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    Address Line         |    744 ESSINGTON RD 
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    City                 |    JOLIET
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    State                |    IL
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    Zip                  |    60435-4912
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    Country              |    US
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    Telephone            |    815-729-0700
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    Fax                  |    815-729-0700
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Authorized Official
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    Title or Position    |    DIRECTOR OF OPERATIONS
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    Name                 |     JIGNESH  PATEL 
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    Credential           |    
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    Telephone            |    815-729-0700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    261QA1903X
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    Taxonomy Name        |    Ambulatory Surgical Clinic/Center
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    License Number       |    
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    License Number State |    
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