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General NPI Number Information
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NPI Number | 1851960876
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Entity Type | Organization
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Legal Business Name | PANDEMIC SOLUTIONS LLC
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Dates
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Enumeration Date | 06/23/2021
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Last Update Date | 06/23/2021
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Provider Practice Location Address
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Address Line | 45 W 111TH ST
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City | CHICAGO
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State | IL
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Zip | 60628-4200
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Country | US
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Telephone | 312-416-4363
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Fax |
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Provider Business Mailing Address
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Address Line | 737 N MICHIGAN AVE STE 960
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City | CHICAGO
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State | IL
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Zip | 60611-6659
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Country | US
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Telephone | 312-416-4363
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING MANAGER
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Name | TINA L TEWS
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Credential |
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Telephone | 317-574-8868
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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 |
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License Number State |
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