NPIMap

Organization Active NPI

The Headache Lab

  • General Practice Physician
  • Evergreen Park, IL
National Provider Identifier
1801782057
Registry record updated Oct 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
THE HEADACHE LAB
Doing business as
The Headache Lab
Practice address
9760 S Kedzie Ave Ste 2
Evergreen Park, IL 60805-3182
Phone
(708) 942-6869
NPI assigned
Jun 16, 2025
Last updated
Oct 8, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
PARK PRIMARY CARE LTDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 8, 2025

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

Authorized official

Name
George Thomas, MDNPI 1073746046
Title
Owner
Phone
(630) 697-8620

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
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

9760 S Kedzie Ave Ste 2
Evergreen Park, IL 60805-3182

Mailing address

9760 S Kedzie Ave Ste 2
Evergreen Park, IL 60805-3182
Phone (708) 942-6869

Other practice location 1

6321 Fairview Ave Ste B
Westmont, IL 60559-2886
Phone (708) 942-6869

Other names 1

  • The Headache Lab Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051222000559 IL Part B Supplier - Clinic/Group Practice 5698797256 Receives reassigned benefits from 12 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Evergreen Park, IL

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Park Primary Care LTD

Locations

9760 S Kedzie Ave
Evergreen Pk, IL 60805
Phone (708) 423-2660

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1750032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759881600000",
    "number": "1801782057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9760 S KEDZIE AVE STE 2",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608053182",
            "telephone_number": "708-942-6869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9760 S KEDZIE AVE STE 2",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608053182",
            "telephone_number": "708-942-6869"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6321 Fairview Ave Ste B",
            "address_purpose": "LOCATION",
            "city": "Westmont",
            "state": "IL",
            "postal_code": "605592886",
            "country_code": "US",
            "telephone_number": "708-942-6869",
            "fax_number": "708-423-8152",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "THE HEADACHE LAB",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PARK PRIMARY CARE LTD",
        "enumeration_date": "2025-06-16",
        "last_updated": "2025-10-08",
        "certification_date": "2025-10-08",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-697-8620",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Headache Lab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Evergreen Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 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.