Immediate Pain Care of Evanston, LLC

Primary specialty

Pain Medicine PhysicianTaxonomy code 208VP0000X

Legal business name

IMMEDIATE PAIN CARE OF EVANSTON, LLC

Practice address

7986 Solutions Ctr
Chicago, IL 60677-1016

Phone

(630) 560-5439

Fax

(630) 701-1007

NPI assigned

May 28, 2014

Organization subpart

No

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

Authorized official

Name

Stuart Bernsen

Title

Ceo

Phone

(630) 560-6506

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1401235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406073600000",
    "number": "1760894554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7986 SOLUTIONS CTR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606771016",
            "telephone_number": "630-560-5439",
            "fax_number": "630-701-1007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7986 SOLUTIONS CTR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606771016",
            "telephone_number": "630-560-5439",
            "fax_number": "630-701-1007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMMEDIATE PAIN CARE OF EVANSTON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-28",
        "last_updated": "2014-07-23",
        "status": "A",
        "authorized_official_last_name": "BERNSEN",
        "authorized_official_first_name": "STUART",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "630-560-6506"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pain Medicine Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Pain Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2014; 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.