Midwest Pain and Spine Physicians LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

MIDWEST PAIN AND SPINE PHYSICIANS LLC

Practice address

4354 W 63Rd St
Chicago, IL 60629-5039

Phone

(773) 482-5800

Fax

(773) 362-2917

NPI assigned

Oct 25, 2018

Organization subpart

No

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

Authorized official

Name

Darrel J. Saldanha

Title

Ceo

Phone

(773) 482-5800

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1540425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540425600000",
    "number": "1962979278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4354 W 63RD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606295039",
            "telephone_number": "773-482-5800",
            "fax_number": "773-362-2768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4354 W 63RD ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606295039",
            "telephone_number": "773-482-5800",
            "fax_number": "773-362-2917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST PAIN AND SPINE PHYSICIANS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-25",
        "last_updated": "2018-10-25",
        "status": "A",
        "authorized_official_last_name": "SALDANHA",
        "authorized_official_first_name": "DARREL",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "773-482-5800"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• General Practice Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2018; 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.