NPIMap

Organization Active NPI

Interventional Spine and Pain Centers, LLC

  • Pain Medicine (Anesthesiology) Physician
  • Munster, IN
National Provider Identifier
1568642601
Registry record updated Apr 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
01062605A Issued in IN
Legal business name
INTERVENTIONAL SPINE AND PAIN CENTERS, LLC
Practice address
8317 Calumet Ave
Suite a
Munster, IN 46321-1737
Phone
(219) 513-2333
Fax
(219) 513-2334
NPI assigned
Nov 6, 2007
Last updated
Apr 20, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2015

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

Authorized official

Name
Dr. Shariq Ibrahim, MDNPI 1245336486
Title
Physician
Phone
(219) 513-2333

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 01062605A IN
Pain Medicine (Anesthesiology) Physician 207LP2900X 01062605A IN Primary

Addresses

Primary practice location

8317 Calumet Ave
Suite a
Munster, IN 46321-1737

Mailing address

8317 Calumet Ave
Suite a
Munster, IN 46321-1737
Phone (219) 513-2333

National Provider Directory

National Provider Directory

Locations

500 Remington Blvd
Bolingbrook, IL 60440
Phone (630) 312-5000

1600 S Lake Park Ave
Hobart, IN 46342
Phone (219) 762-9444

7921 Grand Blvd
Hobart, IN 46342
Phone (219) 942-9600

801 MacArthur Blvd
Ste 400B
Munster, IN 46321

8317 Calumet Ave
Ste A
Munster, IN 46321
Phone (219) 513-2333

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1194307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429488000000",
    "number": "1568642601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8317 CALUMET AVE",
            "address_2": "SUITE A",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463211737",
            "telephone_number": "219-513-2333",
            "fax_number": "219-513-2334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8317 CALUMET AVE",
            "address_2": "SUITE A",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463211737",
            "telephone_number": "219-513-2333",
            "fax_number": "219-513-2334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERVENTIONAL SPINE AND PAIN CENTERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-06",
        "last_updated": "2015-04-20",
        "status": "A",
        "authorized_official_last_name": "IBRAHIM",
        "authorized_official_first_name": "SHARIQ",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "219-513-2333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "01062605A",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "IN",
            "license": "01062605A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Munster, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2015; 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.