Centennial Medical Group Il LLC

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

Legal business name

CENTENNIAL MEDICAL GROUP IL LLC

Practice address

4211 N Cicero Ave Ste 400
Chicago, IL 60641-1649

Phone

(702) 839-1203

NPI assigned

Aug 22, 2025

Organization subpart

No

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

Authorized official

Name

David Lanzkowsky, MD

Title

Owner

Phone

(702) 839-1203

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 1

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.

• Christopher Harb, DO

  • Anesthesiology Physician
  • Gainesville, FL
  • NPI 1982269429

  IL

  Medicare reassignment NPD

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

{
    "created_epoch": "1755820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755820800000",
    "number": "1831077528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4454 N DECATUR BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891305286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4211 N CICERO AVE STE 400",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606411649",
            "telephone_number": "702-839-1203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTENNIAL MEDICAL GROUP IL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-22",
        "last_updated": "2025-08-22",
        "certification_date": "2025-08-22",
        "status": "A",
        "authorized_official_last_name": "LANZKOWSKY",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-839-1203",
        "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": []
}

• Sophie Leyla Cemaj, MD
• Ashley Ceniceros, M.D.
• Nicolas Noel Ceniza
• Cent(Her)Ed Collective
• Centennial Dental Group LTD
• Centennial Medical Management (Nah Community Pharmacy)
• Jacqueline Jenny Centeno
• Jose Antonio Centeno, PSYD
• Center Focused Therapy LLC
• Center for Addictive Problems, Inc

• Interventional Pain Medicine Physician in Chicago, IL
• Providers in Chicago, 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 Aug 22, 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.