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NPI Code Detail

MEDICARE: N R ANESTHESIA & PAIN MANAGEMENT S.C.

MEDICARE: N R ANESTHESIA & PAIN MANAGEMENT S.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QA1903XAmbulatory Surgical Clinic/Center
2207LP2900XPain Medicine (Anesthesiology) Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11636026OTHERILBCBS OF IL PROVIDER #

General Provider Information

NPI Number : 1083655948
Entity Type Code : Organization
Provider Name (Legal Business Name) : N R ANESTHESIA & PAIN MANAGEMENT S.C.
Provider Business Mailing Address
First Line : 4849 W FULLERTON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60639-2503
Country : US
Telephone Number : 773-237-2900
Fax Number : 773-622-0769
Provider Business Practice Location Address
First Line : 4849 W FULLERTON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60639-2503
Country : US
Telephone Number : 773-237-2900
Fax Number : 773-622-0769
Authorized Official
Title or Position : PRESIDENT
Name : NASER RUSTOM
Credential :
Telephone Number : 773-237-2900
Provider Enumeration Date : 06/09/2006
Last Update Date : 01/08/2024

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Directions to “N R ANESTHESIA & PAIN MANAGEMENT S.C. ” Practice Location

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