Organization Active NPI

Pacsa LLC

  • Rehabilitation Practitioner
  • Oak Park, IL
National Provider Identifier
1710268917
Registry record updated Jun 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
License
036117839 Issued in IL
Legal business name
PACSA LLC
Practice address
101 Madison St Ste 300
Oak Park, IL 60302-4210
Phone
(708) 486-2700
Fax
(708) 486-2702
NPI assigned
Aug 31, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2025

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

Authorized official

Name
Dr. Renu R Mahajan, M.D.NPI 1932311883
Title
Owner
Phone
(708) 486-2700

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
Rehabilitation PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 225400000X 036117839 IL Primary

Addresses

Primary practice location

101 Madison St Ste 300
Oak Park, IL 60302-4210

Mailing address

1111 Superior St
Suite 104
Melrose Park, IL 60160-4138
Phone (708) 486-2700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120405000575 IL Part B Supplier - Clinic/Group Practice 0749441491 Receives reassigned benefits from 1 practitioner
Practice locations: Berwyn, IL; Chicago, IL; Melrose Park, IL; Northlake, IL; Oak Park, IL

National Provider Directory

National Provider Directory

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": "1314748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750809600000",
    "number": "1710268917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 SUPERIOR ST",
            "address_2": "SUITE 104",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601604138",
            "telephone_number": "708-486-2700",
            "fax_number": "708-486-2702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MADISON ST STE 300",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603024210",
            "telephone_number": "708-486-2700",
            "fax_number": "708-486-2702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACSA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-31",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-25",
        "status": "A",
        "authorized_official_last_name": "MAHAJAN",
        "authorized_official_first_name": "RENU",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-486-2700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Rehabilitation Practitioner",
            "state": "IL",
            "license": "036117839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2025; 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.