NPIMap

Organization Active NPI

Center for Interventional Pain Management, LLC

  • Pain Clinic/Center
  • Oak Brook, IL
National Provider Identifier
1376867879
Registry record updated Mar 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Clinic/CenterTaxonomy code 261QP3300X
Legal business name
CENTER FOR INTERVENTIONAL PAIN MANAGEMENT, LLC
Practice address
2100 Clearwater Dr Ste 100
Oak Brook, IL 60523-1931
Phone
(630) 607-1000
Fax
(630) 607-1002
NPI assigned
Mar 26, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2014

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

Authorized official

Name
Dr. Nicholas Kondelis, M.D.
Title
Owner
Phone
(630) 607-1000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Clinic/Center 261QP3300X Primary

Addresses

Primary practice location

2100 Clearwater Dr Ste 100
Oak Brook, IL 60523-1931

Mailing address

2100 Clearwater Dr Ste 100
Oak Brook, IL 60523-1931
Phone (630) 607-1000

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1269561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395187200000",
    "number": "1376867879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 CLEARWATER DR STE 100",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231931",
            "telephone_number": "630-607-1000",
            "fax_number": "630-607-1002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 CLEARWATER DR STE 100",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231931",
            "telephone_number": "630-607-1000",
            "fax_number": "630-607-1002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR INTERVENTIONAL PAIN MANAGEMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-26",
        "last_updated": "2014-03-19",
        "status": "A",
        "authorized_official_last_name": "KONDELIS",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-607-1000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Brook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 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.