NPIMap

Organization Active NPI

Fox Valley Pain Center Service Corporation

  • Pain Medicine Physician
  • Elgin, IL
National Provider Identifier
1114037066
Registry record updated Nov 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
License
036077595 Issued in IL
Legal business name
FOX VALLEY PAIN CENTER SERVICE CORPORATION
Practice address
1710 N Randall Rd
370
Elgin, IL 60123-9400
Phone
(847) 888-4432
Fax
(847) 888-4436
NPI assigned
Aug 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2010

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

Authorized official

Name
Dr. Sundararaj R Cherala, M.D
Title
President
Phone
(847) 888-4432

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0000X 036077595 IL Primary

Addresses

Primary practice location

1710 N Randall Rd
370
Elgin, IL 60123-9400

Mailing address

507 Wexford CT
St Charles, IL 60175-5655
Phone (630) 584-8381

National Provider Directory

National Provider Directory

Locations

1710 N Randall Rd
Ste 37
Elgin, IL 60123
Phone (847) 888-4432

Practitioners & affiliated clinicians

Practitioners 22

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.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289433600000",
    "number": "1114037066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "507 WEXFORD CT",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601755655",
            "telephone_number": "630-584-8381",
            "fax_number": "630-524-9018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1710 N RANDALL RD",
            "address_2": "370",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601239400",
            "telephone_number": "847-888-4432",
            "fax_number": "847-888-4436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOX VALLEY PAIN CENTER SERVICE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2010-11-11",
        "status": "A",
        "authorized_official_last_name": "CHERALA",
        "authorized_official_first_name": "SUNDARARAJ",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-888-4432",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "IL",
            "license": "036077595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elgin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.