Organization Active NPI

Regenerative Pain & Spine PLLC

  • Pain Medicine (Anesthesiology) Physician
  • Chicago, IL
National Provider Identifier
1538775770
Registry record updated Jan 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Legal business name
REGENERATIVE PAIN & SPINE PLLC
Practice address
11536 S. Western Ave
Chicago, IL 60643
Phone
(312) 300-3882
Fax
(708) 452-1444
NPI assigned
Sep 22, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2026

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

Authorized official

Name
Dr. Shoeb Mohiuddin, MDNPI 1770928640
Title
Owner
Phone
(708) 691-8841

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
Pain Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LP2900X Primary

Addresses

Primary practice location

11536 S. Western Ave
Chicago, IL 60643

Mailing address

PO Box 719062
Chicago, IL 60677-9286
Phone (312) 300-3882

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220413001567 IL Part B Supplier - Clinic/Group Practice 1355737602 Receives reassigned benefits from 1 practitioner
Practice locations: Chicago, IL

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
14D2327977Regenerative Pain & Spine11536 S Western Ave, Chicago, IL 60643Certificate of waiverJul 31, 2027

National Provider Directory

National Provider Directory

Locations

11536 S Western Ave
Chicago, IL 60643
Phone (312) 300-3882

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1600732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767830400000",
    "number": "1538775770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 719062",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606779286",
            "telephone_number": "312-300-3882",
            "fax_number": "708-452-1444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11536 S. WESTERN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60643",
            "telephone_number": "312-300-3882",
            "fax_number": "708-452-1444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENERATIVE PAIN & SPINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-22",
        "last_updated": "2026-01-08",
        "certification_date": "2026-01-08",
        "status": "A",
        "authorized_official_last_name": "MOHIUDDIN",
        "authorized_official_first_name": "SHOEB",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-691-8841",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2026; 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.