Organization Active NPI

Olson Pain & Stress Management Associates Inc.

  • Specialist
  • Lincolnshire, IL
National Provider Identifier
1629287834
Registry record updated Nov 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
036069815 Issued in IL
Legal business name
OLSON PAIN & STRESS MANAGEMENT ASSOCIATES INC.
Practice address
100 Village Green Dr
#220
Lincolnshire, IL 60069-3095
Phone
(847) 793-8890
Fax
(847) 793-8842
NPI assigned
May 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2008

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

Authorized official

Name
Ms. Elaine E Olson, MD
Title
President
Phone
(847) 793-8890

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 036069815 IL Primary

Addresses

Primary practice location

100 Village Green Dr
#220
Lincolnshire, IL 60069-3095

Mailing address

PO Box 1226
Park Ridge, IL 60068-7226
Phone (847) 793-8890

Other identifiers 3

IdentifierTypeStateIssuer
036069815MedicaidIL
L62349OtherILMC PIN#
21621708OtherILBLUE CROSS BLUESHIELD

National Provider Directory

National Provider Directory

Locations

1020 Milwaukee Ave
Ste 360
Deerfield, IL 60015
Phone (224) 764-2240

100 Village Grn
Ste 220
Lincolnshire, IL 60069
Phone (847) 415-5077

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": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1227052800000",
    "number": "1629287834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1226",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600687226",
            "telephone_number": "847-793-8890",
            "fax_number": "847-793-8892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 VILLAGE GREEN DR",
            "address_2": "#220",
            "city": "LINCOLNSHIRE",
            "state": "IL",
            "postal_code": "600693095",
            "telephone_number": "847-793-8890",
            "fax_number": "847-793-8842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLSON PAIN & STRESS MANAGEMENT ASSOCIATES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2008-11-19",
        "status": "A",
        "authorized_official_last_name": "OLSON",
        "authorized_official_first_name": "ELAINE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-793-8890",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "IL",
            "license": "036069815",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036069815",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MC PIN#",
            "identifier": "L62349",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUESHIELD",
            "identifier": "21621708",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincolnshire, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2008; 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.