Pain & Vascular Institute PLLC
Organization Active NPI Interventional Pain Medicine Physician · Fox River Grove, IL
NPI 1487445334 · NPPES record last updated May 12, 2025
Key facts
- NPI
- 1487445334
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Interventional Pain Medicine Physician 208VP0014X
- Legal business name
- PAIN & VASCULAR INSTITUTE PLLC
- Practice address
- 912 Northwest Hwy Ste 102
Fox River Grove, IL 60021-1925 - Phone
- (573) 872-1306
- NPI assigned
- May 12, 2025
- Organization subpart
- No
Authorized official
- Name
- Dr. Salman Sagarwala, MD
- Title
- President
- Phone
- (573) 872-1306
Practitioners 2
-
Sameer Ahmed, MD
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 14D2333667 | Pain & Vascular Institute PLLC | Certificate of waiver | Nov 7, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20251111003050 | IL | Part B Supplier - Clinic/Group Practice | 9931617495 |
Receives reassigned benefits from 2 practitioners Practice locations: Fox River Grove, IL |
National Provider Directory
Locations
912 Northwest Hwy
Ste 102
Fox River Grv, IL 60021
Phone (224) 357-4001
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vascular & Interventional Radiology Physician |
2085R0204X | |||
| Interventional Pain Medicine Physician |
208VP0014X | Yes |
Addresses
Primary practice location
912 Northwest Hwy Ste 102
Fox River Grove, IL 60021-1925
Mailing address
912 Northwest Hwy Ste 102
Fox River Grove, IL 60021-1925
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All providers in Fox River Grove, IL · Interventional Pain Medicine Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 12, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.