Illinois Pain Specialists, LLC

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

4301089505 Issued in MI

Legal business name

ILLINOIS PAIN SPECIALISTS, LLC

Practice address

1000 Randall Rd
Suite 225
Geneva, IL 60134-2590

Phone

(630) 845-4099

Fax

(630) 845-4098

NPI assigned

Feb 4, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Bojan Pavlovic, M.D.

Title

Owner

Phone

(773) 307-3009

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Geneva Pain Specialists Doing business as

Locations

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

{
    "created_epoch": "1359936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359936000000",
    "number": "1306185913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 RANDALL RD",
            "address_2": "SUITE 225",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601342590",
            "telephone_number": "630-845-4099",
            "fax_number": "630-845-4098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 RANDALL RD",
            "address_2": "SUITE 225",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601342590",
            "telephone_number": "630-845-4099",
            "fax_number": "630-845-4098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLINOIS PAIN SPECIALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-04",
        "last_updated": "2013-02-04",
        "status": "A",
        "authorized_official_last_name": "PAVLOVIC",
        "authorized_official_first_name": "BOJAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-307-3009",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "MI",
            "license": "4301089505",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "036115220",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Geneva Pain Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Interventional Pain Medicine Physician in Geneva, IL
• Providers in Geneva, IL by specialty
• Interventional Pain Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2013; 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.