NPIMap

Organization Active NPI

Midwest Interventional Pain Solutions LLC

Doing business as Midwest Pain and Wellness

  • Pain Medicine (Anesthesiology) Physician
  • Chicago Ridge, IL
National Provider Identifier
1144739582
Registry record updated Oct 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Legal business name
MIDWEST INTERVENTIONAL PAIN SOLUTIONS LLC
Doing business as
Midwest Pain and Wellness
Practice address
10258 Southwest Hwy Ste B
Chicago Ridge, IL 60415-1361
Phone
(708) 571-3669
Fax
(708) 630-0575
NPI assigned
Sep 28, 2017
Last updated
Oct 6, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2022

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

Authorized official

Name
Yaw N Donkoh, MDNPI 1790978492
Title
Owner
Phone
(917) 549-7115

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
Pain Medicine (Anesthesiology) Physician 207LP2900X NU Primary

Addresses

Primary practice location

10258 Southwest Hwy Ste B
Chicago Ridge, IL 60415-1361

Mailing address

PO Box 572
Oak Lawn, IL 60454-0572
Phone (800) 444-6110

Other practice location 1

4440 W 95th St
Oak Lawn, IL 60453-2600
Phone (708) 684-8000

Other names 1

  • Midwest Pain and Wellness Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171025003403 IL Part B Supplier - Clinic/Group Practice 2062788615 Receives reassigned benefits from 4 practitioners
Practice locations: Hazel Crest, IL; Oak Lawn, IL; Chicago Ridge, IL

National Provider Directory

National Provider Directory
Tax ID family
Midwest Interventional Pain2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

10258 Southwest Hwy
Chicago Ridge, IL 60415
Phone (708) 571-3669

10258 Southwest Hwy
Ste B
Chicago Ridge, IL 60415
Phone (708) 571-3669

1206 E 9th St
Ste 270
Lockport, IL 60441

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 4

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": "1506556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665014400000",
    "number": "1144739582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 572",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604540572",
            "telephone_number": "800-444-6110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10258 SOUTHWEST HWY STE B",
            "city": "CHICAGO RIDGE",
            "state": "IL",
            "postal_code": "604151361",
            "telephone_number": "708-571-3669",
            "fax_number": "708-630-0575"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4440 W 95th St",
            "address_purpose": "LOCATION",
            "city": "Oak Lawn",
            "state": "IL",
            "postal_code": "604532600",
            "country_code": "US",
            "telephone_number": "708-684-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MIDWEST INTERVENTIONAL PAIN SOLUTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-28",
        "last_updated": "2022-10-06",
        "certification_date": "2022-10-06",
        "status": "A",
        "authorized_official_last_name": "DONKOH",
        "authorized_official_first_name": "YAW",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-549-7115",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Midwest Pain and Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chicago Ridge, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2022; 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.