Crystal Lake Regenerative Pain Associates PLLC

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

Legal business name

CRYSTAL LAKE REGENERATIVE PAIN ASSOCIATES PLLC

Practice address

750 E Terra Cotta Ave Ste a
Crystal Lake, IL 60014-3621

Phone

(312) 300-3882

NPI assigned

Mar 31, 2022

Organization subpart

No

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

Authorized official

Name

Chad Lee, MD

Title

Owner

Phone

(312) 300-3882

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1648684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648684800000",
    "number": "1750021101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 E TERRA COTTA AVE STE A",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600143621",
            "telephone_number": "312-300-3882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 E TERRA COTTA AVE STE A",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600143621",
            "telephone_number": "312-300-3882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYSTAL LAKE REGENERATIVE PAIN ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-31",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-31",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "312-300-3882",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Interventional Pain Medicine Physician in Crystal Lake, IL
• Providers in Crystal Lake, IL by specialty
• Interventional Pain Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2022; 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.