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NPI Code Detail

MEDICARE: RX PAIN MANAGEMENT

MEDICARE: RX PAIN MANAGEMENT
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
1207Q00000XFamily Medicine PhysicianIL
2208D00000XGeneral Practice PhysicianIL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11620404OTHERILBCBS

General Provider Information

NPI Number : 1851404131
Entity Type Code : Organization
Provider Name (Legal Business Name) : RX PAIN MANAGEMENT
Provider Business Mailing Address
First Line : 229 W 25TH PL
Second Line :
City : CHICAGO
State : IL
Zip : 60616-2220
Country : US
Telephone Number : 773-247-2131
Fax Number : 773-247-3110
Provider Business Practice Location Address
First Line : 736 W 35TH ST
Second Line :
City : CHICAGO
State : IL
Zip : 60616-4484
Country : US
Telephone Number : 773-247-2131
Fax Number : 773-247-3110
Authorized Official
Title or Position : PHYSICIAN
Name : DR. DALMACIO CUSI
Credential : MD
Telephone Number : 773-247-2131
Provider Enumeration Date : 08/17/2006
Last Update Date : 09/11/2025

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Directions to “RX PAIN MANAGEMENT ” Practice Location

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