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General NPI Number Information
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NPI Number | 1871522631
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Entity Type | Organization
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Legal Business Name | MIDWEST PHYSICAN PAIN CENTER
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Dates
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Enumeration Date | 07/02/2006
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Last Update Date | 09/29/2023
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Provider Practice Location Address
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Address Line | 3522 E 95TH ST
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City | CHICAGO
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State | IL
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Zip | 60617-5164
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Country | US
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Telephone | 630-202-2230
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Fax | 773-933-4903
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Provider Business Mailing Address
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Address Line | 8 CASCADE CT W
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City | BURR RIDGE
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State | IL
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Zip | 60527-0715
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Country | US
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Telephone | 630-887-1482
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Fax | 773-933-4903
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Authorized Official
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Title or Position | OWNER
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Name | RANJIT SINGH WAHI
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Credential | MD
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Telephone | 773-933-0791
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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