NPIMap

Organization Active NPI

The Pain Center of Illinois Inc.

  • Pain Medicine (Anesthesiology) Physician
  • Chicago, IL
National Provider Identifier
1053588079
Registry record updated Sep 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Legal business name
THE PAIN CENTER OF ILLINOIS INC.
Practice address
2041 W Division St
Chicago, IL 60622-8521
Phone
(312) 624-8364
Fax
(312) 929-3323
NPI assigned
May 8, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Neema Bayran, MDNPI 1780611756
Title
C.E.O.
Phone
(312) 593-1580

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 036-103729 IL
Pain Medicine (Anesthesiology) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207LP2900X Primary

Addresses

Primary practice location

2041 W Division St
Chicago, IL 60622-8521

Mailing address

2041 W Division St
Chicago, IL 60622-8521
Phone (312) 624-8364

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081030000799 IL Part B Supplier - Clinic/Group Practice 7214096593 Receives reassigned benefits from 10 practitioners
Practice locations: Chicago, IL; Elmhurst, IL; Lansing, IL; Oak Park, IL

National Provider Directory

National Provider Directory

Locations

300 W Butterfield Rd
Ste 105
Elmhurst, IL 60126
Phone (630) 474-3735

16909 Torrence Ave
Lansing, IL 60438
Phone (708) 394-0154

836 S Oak Park Ave
Oak Park, IL 60304
Phone (708) 613-5471

Practitioners & affiliated clinicians

Practitioners 33

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 33

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1210204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727136000000",
    "number": "1053588079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2041 W DIVISION ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606228521",
            "telephone_number": "312-624-8364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2041 W DIVISION ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606228521",
            "telephone_number": "312-624-8364",
            "fax_number": "312-929-3323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PAIN CENTER OF ILLINOIS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-08",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A",
        "authorized_official_last_name": "BAYRAN",
        "authorized_official_first_name": "NEEMA",
        "authorized_official_title_or_position": "C.E.O.",
        "authorized_official_telephone_number": "312-593-1580",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "IL",
            "license": "036-103729",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.