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General NPI Number Information
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NPI Number | 1821548215
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL ANESTHESIOLOGY INTERVENTIONAL NETWORK, INC
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Dates
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Enumeration Date | 10/10/2016
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Last Update Date | 09/18/2025
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Provider Practice Location Address
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Address Line | 1921 S MICHIGAN AVE
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City | CHICAGO
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State | IL
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Zip | 60616-1603
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Country | US
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Telephone | 312-414-1088
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Fax | 312-920-1799
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Provider Business Mailing Address
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Address Line | 1921 S MICHIGAN AVE
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City | CHICAGO
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State | IL
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Zip | 60616-1603
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Country | US
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Telephone | 312-414-1088
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Fax | 312-920-1799
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | NIDAL ELBARIDI
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Credential | MD
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Telephone | 312-414-1088
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 05005794A
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License Number State | IN
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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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Taxonomy #3
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 261710
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License Number State | MA
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Taxonomy #4
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 036134543
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License Number State | IL
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