NPIMap

Organization Active NPI

Illinois Pain Treatment Institute, LTD

  • Pain Clinic/Center
  • St Charles, IL
National Provider Identifier
1376221473
Registry record updated Apr 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Clinic/CenterTaxonomy code 261QP3300X
Legal business name
ILLINOIS PAIN TREATMENT INSTITUTE, LTD
Practice address
2455 Dean St Ste 3G
St Charles, IL 60175-4830
Phone
(847) 289-8822
Fax
(847) 289-0815
NPI assigned
Jul 7, 2023
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, MD
Title
Medical Director
Phone
(847) 289-8822

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine Physician 208VP0000X NU
Interventional Pain Medicine Physician 208VP0014X NU
Pain Clinic/Center 261QP3300X NU Primary

Addresses

Primary practice location

2455 Dean St Ste 3G
St Charles, IL 60175-4830

Mailing address

431 Summit St
Elgin, IL 60120-3805
Phone (847) 289-8822

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240118001281 IL DME Supplier - Physician - Interventional Pain ManagementDME Supplier - Physician - Anesthesiology 3577464940 Practice locations: St Charles, IL

Other NPIs with the same Medicare PAC ID 4

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

National Provider Directory

National Provider Directory
Tax ID family
Illinois Pain Treatment Institute LTD3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1688688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745193600000",
    "number": "1376221473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "431 SUMMIT ST",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601203805",
            "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": "2455 DEAN ST STE 3G",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601754830",
            "telephone_number": "847-289-8822",
            "fax_number": "847-289-0815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLINOIS PAIN TREATMENT INSTITUTE, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-07",
        "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": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Charles, 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.