Organization Active NPI

Greater Elgin Pain Management Consultants SC

  • Pain Medicine (Anesthesiology) Physician
  • Elgin, IL
National Provider Identifier
1205916707
Registry record updated Aug 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Legal business name
GREATER ELGIN PAIN MANAGEMENT CONSULTANTS SC
Practice address
1425 N Randall Rd
Elgin, IL 60123-2300
Phone
(847) 220-1418
Fax
(224) 783-3088
NPI assigned
Oct 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2021

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

Authorized official

Name
Joanna Barclay, MDNPI 1932210978
Title
MD
Phone
(847) 220-1418

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) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207LP2900X Primary

Addresses

Primary practice location

1425 N Randall Rd
Elgin, IL 60123-2300

Mailing address

Dept 4423
Carol Stream, IL 60122-0001
Phone (847) 220-1418

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061226000088 IL Part B Supplier - Clinic/Group Practice 1254331226 Receives reassigned benefits from 2 practitioners
Practice locations: Elgin, IL

National Provider Directory

National Provider Directory

Locations

Dept 4423
Carol Stream, IL 60122

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": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628812800000",
    "number": "1205916707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT 4423",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601220001",
            "telephone_number": "847-220-1418",
            "fax_number": "224-783-3088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 N RANDALL RD",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601232300",
            "telephone_number": "847-220-1418",
            "fax_number": "224-783-3088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER ELGIN PAIN MANAGEMENT CONSULTANTS SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2021-08-13",
        "certification_date": "2021-08-13",
        "status": "A",
        "authorized_official_last_name": "BARCLAY",
        "authorized_official_first_name": "JOANNA",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "847-220-1418",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "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 Aug 13, 2021; 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.