NPIMap

Organization Active NPI

Guardian Headache & Pain Management Institute

  • Pain Clinic/Center
  • Bloomington, IL
National Provider Identifier
1598061103
Registry record updated Jul 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Clinic/CenterTaxonomy code 261QP3300X
Legal business name
GUARDIAN HEADACHE & PAIN MANAGEMENT INSTITUTE
Practice address
2203 Eastland Dr
Suite 7
Bloomington, IL 61704-7918
Phone
(800) 444-6110
Fax
(847) 615-2858
NPI assigned
Jan 28, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2015

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

Authorized official

Name
Dr. Benjamin Taimoorazy, MDNPI 1134225790
Title
Owner
Phone
(309) 287-7601

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 Clinic/Center 261QP3300X Primary

Addresses

Primary practice location

2203 Eastland Dr
Suite 7
Bloomington, IL 61704-7918

Mailing address

PO Box 5488
Peoria, IL 61601-5488
Phone (800) 444-6110

National Provider Directory

National Provider Directory
Tax ID family
Guardian Headache Pain Management Institute3 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.

Practitioners & affiliated clinicians

Practitioners 4

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": "1296172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437436800000",
    "number": "1598061103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5488",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616015488",
            "telephone_number": "800-444-6110",
            "fax_number": "847-615-2858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2203 EASTLAND DR",
            "address_2": "SUITE 7",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617047918",
            "telephone_number": "800-444-6110",
            "fax_number": "847-615-2858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUARDIAN HEADACHE & PAIN MANAGEMENT INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-28",
        "last_updated": "2015-07-21",
        "status": "A",
        "authorized_official_last_name": "TAIMOORAZY",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "309-287-7601",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.