NPIMap

Organization Active NPI

Suburban Paincare Center P.C.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Naperville, IL
National Provider Identifier
1255443222
Registry record updated Sep 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
Legal business name
SUBURBAN PAINCARE CENTER P.C.
Practice address
535 S Washington St
Ste 22
Naperville, IL 60540-6795
Phone
(630) 810-0451
Fax
(877) 446-3870
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2014

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

Authorized official

Name
Dr. Elton Wade Dixon, M.D.
Title
Owner/Physician
Phone
(630) 810-0451

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2081P2900X Primary
Pain Medicine (Psychiatry & Neurology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P2900X

Addresses

Primary practice location

535 S Washington St
Ste 22
Naperville, IL 60540-6795

Mailing address

18660 Graphic Dr
Ste 100
Tinley Park, IL 60477-6260
Phone (630) 810-0451

Other identifiers 1

IdentifierTypeStateIssuer
1633419OtherILBCBS PROVIDER NUMBER

National Provider Directory

National Provider Directory

Locations

19720 Governors Hwy
Flossmoor, IL 60422
Phone (630) 810-0451

535 S Washington St
Ste 23
Naperville, IL 60540
Phone (331) 472-4245

535 S Washington St
Ste 22
Naperville, IL 60540
Phone (331) 472-4245

73 W 61st St
Westmont, IL 60559
Phone (630) 810-0451

Practitioners & affiliated clinicians

Practitioners 8

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": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409875200000",
    "number": "1255443222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18660 GRAPHIC DR",
            "address_2": "STE 100",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604776260",
            "telephone_number": "630-810-0451",
            "fax_number": "877-446-3870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 S WASHINGTON ST",
            "address_2": "STE 22",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605406795",
            "telephone_number": "630-810-0451",
            "fax_number": "877-446-3870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUBURBAN PAINCARE CENTER P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2014-09-05",
        "status": "A",
        "authorized_official_last_name": "DIXON",
        "authorized_official_first_name": "ELTON",
        "authorized_official_middle_name": "WADE",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "630-810-0451",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "1633419",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2014; 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.