NPIMap

Organization Active NPI

Kankakee Pain Surgical Suite, LLC

  • Pain Clinic/Center
  • Kankakee, IL
National Provider Identifier
1982844684
Registry record updated Feb 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Clinic/CenterTaxonomy code 261QP3300X
Legal business name
KANKAKEE PAIN SURGICAL SUITE, LLC
Practice address
555 W Court St
Suite 100
Kankakee, IL 60901-3664
Phone
(815) 932-7246
Fax
(815) 932-7307
NPI assigned
Feb 20, 2009
Organization subpart
Yes
Parent organization
METRO AREA PAIN CONSULTANTS, LTD.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 20, 2009

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

Authorized official

Name
Dr. Donald E. Roland, M.D.
Title
President
Phone
(815) 932-7246

Specialties & licenses 1

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

Addresses

Primary practice location

555 W Court St
Suite 100
Kankakee, IL 60901-3664

Mailing address

555 W Court St
Suite 100
Kankakee, IL 60901-3664
Phone (815) 932-7246

National Provider Directory

National Provider Directory
Part of
Metro Area Pain Consultants LTD

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1235088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235088000000",
    "number": "1982844684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 W COURT ST",
            "address_2": "SUITE 100",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609013664",
            "telephone_number": "815-932-7246",
            "fax_number": "815-932-7307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 W COURT ST",
            "address_2": "SUITE 100",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609013664",
            "telephone_number": "815-932-7246",
            "fax_number": "815-932-7307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KANKAKEE PAIN SURGICAL SUITE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "METRO AREA PAIN CONSULTANTS, LTD.",
        "enumeration_date": "2009-02-20",
        "last_updated": "2009-02-20",
        "status": "A",
        "authorized_official_last_name": "ROLAND",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-932-7246",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kankakee, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2009; 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.