NPIMap

Organization Active NPI

N R Anesthesia & Pain Management S.C.

  • Pain Medicine (Anesthesiology) Physician
  • Chicago, IL
National Provider Identifier
1083655948
Registry record updated Jan 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Legal business name
N R ANESTHESIA & PAIN MANAGEMENT S.C.
Practice address
4849 W Fullerton Ave
Chicago, IL 60639-2503
Phone
(773) 237-2900
Fax
(773) 622-0769
NPI assigned
Jun 9, 2006
Last updated
Jan 8, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2024

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

Authorized official

Name
Naser Rustom
Title
President
Phone
(773) 237-2900

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X NU
Pain Medicine (Anesthesiology) Physician 207LP2900X NU Primary

Addresses

Primary practice location

4849 W Fullerton Ave
Chicago, IL 60639-2503

Mailing address

4849 W Fullerton Ave
Chicago, IL 60639-2503
Phone (773) 237-2900

Other identifiers 1

IdentifierTypeStateIssuer
1636026OtherILBCBS OF IL PROVIDER #

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061226000164 IL Part B Supplier - Clinic/Group Practice 7618977596 Receives reassigned benefits from 12 practitioners
Practice locations: Chicago, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704672000000",
    "number": "1083655948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4849 W FULLERTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606392503",
            "telephone_number": "773-237-2900",
            "fax_number": "773-622-0769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4849 W FULLERTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606392503",
            "telephone_number": "773-237-2900",
            "fax_number": "773-622-0769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "N R ANESTHESIA & PAIN MANAGEMENT S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-09",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-08",
        "status": "A",
        "authorized_official_last_name": "RUSTOM",
        "authorized_official_first_name": "NASER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-237-2900"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF IL PROVIDER #",
            "identifier": "1636026",
            "state": "IL"
        }
    ],
    "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 Jan 8, 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.