Organization Active NPI

Pain Care Advisors, LLC

  • Pain Medicine (Anesthesiology) Physician
  • Niles, IL
National Provider Identifier
1699250647
Registry record updated Sep 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
Legal business name
PAIN CARE ADVISORS, LLC
Practice address
7437 N Harlem Ave
Niles, IL 60714-3701
Phone
(847) 744-9373
NPI assigned
Sep 26, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2018

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

Authorized official

Name
Dr. Henry S Kurzydlowski, MDNPI 1073570198
Title
President
Phone
(847) 373-6484

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: 193400000X SINGLE SPECIALTY GROUP 207LP2900X Primary

Addresses

Primary practice location

7437 N Harlem Ave
Niles, IL 60714-3701

Mailing address

PO Box 1123
Jackson, MI 49204-1123
Phone (517) 787-6440

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190111002292 IL Part B Supplier - Clinic/Group Practice 1153667142 Receives reassigned benefits from 1 practitioner
Practice locations: Chicago, IL; Niles, IL; Morton Grove, IL

National Provider Directory

National Provider Directory

Locations

7437 N Harlem Ave
Niles, IL 60714
Phone (847) 387-3864

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": "1537920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537920000000",
    "number": "1699250647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1123",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492041123",
            "telephone_number": "517-787-6440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7437 N HARLEM AVE",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607143701",
            "telephone_number": "847-744-9373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN CARE ADVISORS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-26",
        "last_updated": "2018-09-26",
        "status": "A",
        "authorized_official_last_name": "KURZYDLOWSKI",
        "authorized_official_first_name": "HENRY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-373-6484",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niles, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2018; 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.