Organization Active NPI

Advanced Pain Consultants, S.C.

  • Interventional Pain Medicine Physician
  • Oak Brook, IL
National Provider Identifier
1164567236
Registry record updated Mar 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
Legal business name
ADVANCED PAIN CONSULTANTS, S.C.
Practice address
2100 Clearwater Dr Ste 100
Oak Brook, IL 60523-1931
Phone
(630) 607-1000
Fax
(630) 607-1002
NPI assigned
Feb 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2025

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

Authorized official

Name
Nicholas Kondelis, MDNPI 1346282126
Title
President & Ceo
Phone
(630) 607-1000

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
Pain Medicine (Anesthesiology) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207LP2900X
Interventional Pain Medicine Physician 208VP0014X Primary

Addresses

Primary practice location

2100 Clearwater Dr Ste 100
Oak Brook, IL 60523-1931

Mailing address

2100 Clearwater Dr Ste 100
Oak Brook, IL 60523-1931
Phone (630) 607-1000

Other identifiers 1

IdentifierTypeStateIssuer
036070815MedicaidIL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070926000785 IL Part B Supplier - Clinic/Group Practice 8325132988 Receives reassigned benefits from 5 practitioners
Practice locations: Oak Brook, IL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D1101138Advanced Pain Consultants S C2100 Clearwater Dr, Ste 100, Oak Brook, IL 60523Certificate of waiverJun 21, 2027

National Provider Directory

National Provider Directory

Locations

33 N Addison Rd
Ste 206
Addison, IL 60101

205 W Main St
Barrington, IL 60010
Phone (847) 842-6900

Practitioners & affiliated clinicians

Practitioners 6

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": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742774400000",
    "number": "1164567236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 CLEARWATER DR STE 100",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231931",
            "telephone_number": "630-607-1000",
            "fax_number": "630-607-1002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 CLEARWATER DR STE 100",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231931",
            "telephone_number": "630-607-1000",
            "fax_number": "630-607-1002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED PAIN CONSULTANTS, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2025-03-24",
        "certification_date": "2025-03-24",
        "status": "A",
        "authorized_official_last_name": "KONDELIS",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "630-607-1000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036070815",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Brook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.