Organization Active NPI

Illinois Anesthesia and Pain Associates SC

  • Pain Medicine (Anesthesiology) Physician
  • Frankfort, IL
National Provider Identifier
1609169945
Registry record updated Aug 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
036100713 Issued in IL
Legal business name
ILLINOIS ANESTHESIA AND PAIN ASSOCIATES SC
Practice address
11634 Quartz CT
Frankfort, IL 60423-9028
Phone
(708) 479-6522
Fax
(708) 286-6461
NPI assigned
May 19, 2011
Last updated
Aug 9, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2011

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

Authorized official

Name
Dr. Yasser Hussein, MD
Title
President
Phone
(815) 726-2368

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Anesthesiology) Physician 207LP2900X 036100713 IL Primary

Addresses

Primary practice location

11634 Quartz CT
Frankfort, IL 60423-9028

Mailing address

1301 Copperfield Ave Ste 206
Joliet, IL 60432-2056
Phone (708) 479-6522

Other identifiers 1

IdentifierTypeStateIssuer
036100713MedicaidIL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110805000759 IL Part B Supplier - Clinic/Group Practice 5395914402 Receives reassigned benefits from 1 practitioner
Practice locations: Frankfort, IL

National Provider Directory

National Provider Directory

Locations

1301 Copperfield Ave
Ste 206
Joliet, IL 60432
Phone (815) 723-4551

375 N Wall St
Ste P530
Kankakee, IL 60901
Phone (815) 932-7200

Practitioners & affiliated clinicians

Practitioners 1

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": "1305763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312848000000",
    "number": "1609169945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 COPPERFIELD AVE STE 206",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604322056",
            "telephone_number": "708-479-6522",
            "fax_number": "708-286-6461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11634 QUARTZ CT",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "604239028",
            "telephone_number": "708-479-6522",
            "fax_number": "708-286-6461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLINOIS ANESTHESIA AND PAIN ASSOCIATES SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-19",
        "last_updated": "2011-08-09",
        "status": "A",
        "authorized_official_last_name": "HUSSEIN",
        "authorized_official_first_name": "YASSER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-726-2368",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "IL",
            "license": "036100713",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036100713",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Frankfort, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.