NPIMap

Organization Active NPI

Illinois Pain Treatment Institute, LTD

  • Interventional Pain Medicine Physician
  • Elgin, IL
National Provider Identifier
1295811479
Registry record updated Apr 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
Legal business name
ILLINOIS PAIN TREATMENT INSTITUTE, LTD
Practice address
431 Summit
Elgin, IL 60120
Phone
(847) 289-8822
Fax
(847) 289-0815
NPI assigned
Oct 31, 2006
Last updated
Apr 21, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2025

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

Authorized official

Name
Chadi Iskandar Yaacoub, MDNPI 1760690028
Title
Medical Director
Phone
(847) 289-8822

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
Interventional Pain Medicine Physician 208VP0014X Primary

Addresses

Primary practice location

431 Summit
Elgin, IL 60120

Mailing address

431 Summit
Elgin, IL 60120
Phone (847) 289-8822

Other identifiers 4

IdentifierTypeStateIssuer
1619144OtherBC
DA 3105OtherILRAILROAD MEDICARE
CM 4844OtherILRAILROAD MEDICARE
CA 2780OtherILRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040119000131 IL Part B Supplier - Clinic/Group Practice 3577464940 Receives reassigned benefits from 36 practitioners
Practice locations: St Charles, IL; McHenry, IL; Libertyville, IL; Itasca, IL; Huntley, IL; Elgin, IL; Barrington, IL; Lake Barrington, IL
O20190211001462 IL DME Supplier - Physician - General Practice 3577464940 Practice locations: Elgin, IL

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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
14D1001786Illinois Pain Institute431 Summit St, Elgin, IL 60120Certificate of waiverJul 21, 2028

National Provider Directory

National Provider Directory

Locations

2455 Dean St
Ste 2G
Saint Charles, IL 60175

2455 Dean St
Ste 3G
St Charles, IL 60175
Phone (630) 254-8872

Practitioners & affiliated clinicians

Practitioners 39

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 39

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745193600000",
    "number": "1295811479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "431 SUMMIT",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "60120",
            "telephone_number": "847-289-8822",
            "fax_number": "847-289-0815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "431 SUMMIT",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "60120",
            "telephone_number": "847-289-8822",
            "fax_number": "847-289-0815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLINOIS PAIN TREATMENT INSTITUTE, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-31",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-21",
        "status": "A",
        "authorized_official_last_name": "YAACOUB",
        "authorized_official_first_name": "CHADI",
        "authorized_official_middle_name": "ISKANDAR",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "847-289-8822",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC",
            "identifier": "1619144",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DA 3105",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CM 4844",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CA 2780",
            "state": "IL"
        }
    ],
    "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 Apr 21, 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.