Advanced Pain & Back Institute, Inc.

Key facts

NPI

1851765804

Entity type

Organization (NPI type 2)

Primary specialty

Interventional Pain Medicine Physician 208VP0014X

License

036130509 (IL)

Legal business name

ADVANCED PAIN & BACK INSTITUTE, INC.

Practice address

5425 W Belmont Ave
Chicago, IL 60641-4127

Phone

(312) 702-1313

Fax

(844) 269-6602

NPI assigned

Nov 13, 2015

Organization subpart

No

Authorized official

Name

Dr. Hong Xuan Vo, M.D. NPI 1447419940

Title

President

Phone

(832) 348-9475

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 3

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

• Hong Xuan Vo, M.D. Interventional Pain Medicine Physician · Chicago, IL · NPI 1447419940
  Medicare reassignment Care Compare group NPD Authorized official IL · INTERVENTIONAL PAIN MEDICINE
• Venus Liezl Basnillo, APN Adult Health Nurse Practitioner · Chicago, IL · NPI 1265971204
  Medicare reassignment Care Compare group NPD IL
• Anjum Khan, MD Physical Medicine & Rehabilitation Physician · Chicago, IL · NPI 1851413173
  Medicare reassignment NPD IL

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

Medicare participation

Medicare fee-for-service enrollment

Enrolled (2 enrollments) in IL

Medicare enrollment records

National Provider Directory

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 20, 2019.

{
    "created_epoch": "1447372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553040000000",
    "number": "1851765804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5425 W BELMONT AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606414127",
            "telephone_number": "312-702-1313",
            "fax_number": "844-269-6602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5425 W BELMONT AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606414127",
            "telephone_number": "312-702-1313",
            "fax_number": "844-269-6602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED PAIN & BACK INSTITUTE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-13",
        "last_updated": "2019-03-20",
        "status": "A",
        "authorized_official_last_name": "VO",
        "authorized_official_first_name": "HONG",
        "authorized_official_middle_name": "XUAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "832-348-9475",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "IL",
            "license": "036130509",
            "primary": true
        },
        {
            "code": "283X00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Hospital",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036130509",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Advanced Physical Medicine Associates, S.C.

All providers in Chicago, IL · Interventional Pain Medicine Physician in Illinois