NPIMap

Organization Active NPI

Aaa Headache and Pain Clinic LTD

  • Pain Clinic/Center
  • Libertyville, IL
National Provider Identifier
1952565384
Registry record updated Jul 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Clinic/CenterTaxonomy code 261QP3300X
License
036119222 Issued in IL
Legal business name
AAA HEADACHE AND PAIN CLINIC LTD
Practice address
1449 N Milwaukee Ave
Libertyville, IL 60048-1310
Phone
(916) 203-5795
NPI assigned
Jul 15, 2008
Last updated
Jul 28, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2008

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

Authorized official

Name
Dr. Maxim Gorelik, MD
Title
President
Phone
(916) 203-5795

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Clinic/Center 261QP3300X 036119222 IL Primary

Addresses

Primary practice location

1449 N Milwaukee Ave
Libertyville, IL 60048-1310

Mailing address

1449 N Milwaukee Ave
Libertyville, IL 60048-1310
Phone (916) 203-5795

National Provider Directory

National Provider Directory

Locations

1655 N Arlington Heights Rd
Ste 101
Arlington Heights, IL 60004
Phone (847) 305-3610

1870 W Winchester Rd
Ste 144
Libertyville, IL 60048
Phone (847) 548-5063

Practitioners & affiliated clinicians

Practitioners 4

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": "1216080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217203200000",
    "number": "1952565384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1449 N MILWAUKEE AVE",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600481310",
            "telephone_number": "916-203-5795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1449 N MILWAUKEE AVE",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600481310",
            "telephone_number": "916-203-5795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AAA HEADACHE AND PAIN CLINIC LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-15",
        "last_updated": "2008-07-28",
        "status": "A",
        "authorized_official_last_name": "GORELIK",
        "authorized_official_first_name": "MAXIM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "916-203-5795",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": "IL",
            "license": "036119222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Libertyville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2008; 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.