Brookside Advanced Clinic for Pain,Inc.

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

License

209003563 Issued in IL

Legal business name

BROOKSIDE ADVANCED CLINIC FOR PAIN,INC.

Practice address

21120 Washington Pkwy
Frankfort, IL 60423-3112

Phone

(815) 469-9750

Fax

(815) 469-9752

NPI assigned

Jan 14, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Daniel W Borvan

Title

President

Phone

(815) 469-9750

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1231891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231891200000",
    "number": "1730326687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21120 WASHINGTON PKWY",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "604233112",
            "telephone_number": "815-469-9750",
            "fax_number": "815-469-9752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21120 WASHINGTON PKWY",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "604233112",
            "telephone_number": "815-469-9750",
            "fax_number": "815-469-9752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKSIDE ADVANCED CLINIC FOR PAIN,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-14",
        "last_updated": "2009-01-14",
        "status": "A",
        "authorized_official_last_name": "BORVAN",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-469-9750",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "IL",
            "license": "209003563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jane Anne Braun, PH.D.
• Robyn Braun, RBT
• Erin Marie Bresnahan, OTR/L, MS
• Marsha L Broers, MA
• John Joseph Brolley
• Brookside Dental Care, LTD.
• Brotschul Health Care, S.C. (Access Wellness Center)
• Daniel Jason Brotschul, D.C.
• Amy Suszko Brown, PSY.D.
• Emily Brown, BCBA

• Pain Medicine (Anesthesiology) Physician in Frankfort, IL
• Providers in Frankfort, IL by specialty
• Pain Medicine (Anesthesiology) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2009; 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.