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General NPI Number Information
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NPI Number | 1972367936
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Entity Type | Organization
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Legal Business Name | MIDWEST PAIN CENTERS LLC
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Dates
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Enumeration Date | 02/09/2024
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Last Update Date | 02/16/2025
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Provider Practice Location Address
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Address Line | 301 MADISON ST STE 305
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City | JOLIET
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State | IL
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Zip | 60435-6655
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Country | US
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Telephone | 815-729-0450
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Fax |
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Provider Business Mailing Address
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Address Line | 301 MADISON ST STE 305
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City | JOLIET
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State | IL
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Zip | 60435-6655
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | AMMAR WAHOOD
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Credential | MD
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Telephone | 815-729-0450
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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 |
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License Number State |
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