Organization Active NPI

Equinox Medical and Pain Management Center

  • Physical Medicine & Rehabilitation Physician
  • Niles, IL
National Provider Identifier
1831434430
Registry record updated Dec 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
036-108386 Issued in IL
Legal business name
EQUINOX MEDICAL AND PAIN MANAGEMENT CENTER
Practice address
7900 N Milwaukee Ave Ste 2-29
Niles, IL 60714-3237
Phone
(708) 705-7109
Fax
(708) 788-1942
NPI assigned
Dec 7, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2012

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

Authorized official

Name
Mr. Paul Rohacek
Title
Executive Manager
Phone
(708) 705-7109

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X 036-108386 IL Primary

Addresses

Primary practice location

7900 N Milwaukee Ave Ste 2-29
Niles, IL 60714-3237

Mailing address

7900 N Milwaukee Ave Ste 2-29
Niles, IL 60714-3237
Phone (708) 705-7109

National Provider Directory

National Provider Directory

Locations

7900 N Milwaukee Ave
Ste 2
Niles, IL 60714
Phone (847) 967-9430

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1354838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354838400000",
    "number": "1831434430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7900 N MILWAUKEE AVE STE 2-29",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607143237",
            "telephone_number": "708-705-7109",
            "fax_number": "708-788-1942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7900 N MILWAUKEE AVE STE 2-29",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607143237",
            "telephone_number": "708-705-7109",
            "fax_number": "708-788-1942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EQUINOX MEDICAL AND PAIN MANAGEMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-07",
        "last_updated": "2012-12-07",
        "status": "A",
        "authorized_official_last_name": "ROHACEK",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "EXECUTIVE MANAGER",
        "authorized_official_telephone_number": "708-705-7109",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IL",
            "license": "036-108386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niles, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2012; 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.