NPIMap

Organization Active NPI

Pain and Wellness Specialists SC

  • Physical Medicine & Rehabilitation Physician
  • Itasca, IL
National Provider Identifier
1104294784
Registry record updated Jan 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
PAIN AND WELLNESS SPECIALISTS SC
Practice address
535 S Elm St
Itasca, IL 60143-2187
Phone
(630) 773-9416
Fax
(630) 397-0022
NPI assigned
Sep 12, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2024

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

Authorized official

Name
Madhu K Singh, MDNPI 1225243983
Title
President
Phone
(205) 821-8680

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

535 S Elm St
Itasca, IL 60143-2187

Mailing address

PO Box 3
Glenview, IL 60025-0003
Phone (847) 943-9457

Other practice location 1

311 Edgewater Dr
Bloomingdale, IL 60108-1979
Phone (630) 894-7400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151015000724 IL Part B Supplier - Clinic/Group Practice 2264741156 Receives reassigned benefits from 2 practitioners
Practice locations: Bloomingdale, IL; Itasca, IL

National Provider Directory

National Provider Directory

Locations

311 Edgewater Dr
Bloomingdale, IL 60108
Phone (630) 894-7400

311 Edgewater Dr
#200
Bloomingdale, IL 60108

747 Lake Cook Rd
Ste 22E
Deerfield, IL 60015

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1442016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706486400000",
    "number": "1104294784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600250003",
            "telephone_number": "847-943-9457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 S ELM ST",
            "city": "ITASCA",
            "state": "IL",
            "postal_code": "601432187",
            "telephone_number": "630-773-9416",
            "fax_number": "630-397-0022"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "311 Edgewater Dr",
            "address_purpose": "LOCATION",
            "city": "Bloomingdale",
            "state": "IL",
            "postal_code": "601081979",
            "country_code": "US",
            "telephone_number": "630-894-7400",
            "fax_number": "630-894-8528",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PAIN AND WELLNESS SPECIALISTS SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-12",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A",
        "authorized_official_last_name": "SINGH",
        "authorized_official_first_name": "MADHU",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "205-821-8680",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Itasca, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 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.