MEDICARE: NILES CARE CENTER PLLC

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
1	207LP2900X	Pain Medicine (Anesthesiology) Physician

General Provider Information

NPI Number	:	1265378012
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NILES CARE CENTER PLLC

Provider Business Mailing Address
First Line	:	8565 W DEMPSTER ST
Second Line	:
City	:	NILES
State	:	IL
Zip	:	60714-1401
Country	:	US
Telephone Number	:	847-299-7000
Fax Number	:

Provider Business Practice Location Address
First Line	:	8565 W DEMPSTER ST
Second Line	:
City	:	NILES
State	:	IL
Zip	:	60714-1401
Country	:	US
Telephone Number	:	847-299-7000
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. PETER SLAVIN
Credential	:	DC
Telephone Number	:	847-299-7000

Provider Enumeration Date	:	04/24/2026
Last Update Date	:	04/24/2026

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