MEDICARE: MILESTONE PAIN AND REHABILITATION,PC

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	261QP3300X	Pain Clinic/Center

General Provider Information

NPI Number	:	1386686665
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MILESTONE PAIN AND REHABILITATION,PC

Provider Business Mailing Address
First Line	:	8981 RELIABLE PKWY
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60686-0001
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7055 TOWER RD
Second Line	:	SUITE C
City	:	BATTLE CREEK
State	:	MI
Zip	:	49014-8604
Country	:	US
Telephone Number	:	269-965-8001
Fax Number	:

Authorized Official
Title or Position	:	PH.D., M.D.
Name	:	GHOLAMREZA SHAREGHI
Credential	:
Telephone Number	:	269-965-8001

Provider Enumeration Date	:	06/12/2006
Last Update Date	:	08/22/2020

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