MEDICOS PAIN & SURGICAL SPECIALISTS, S.C. (NPI# 1003063108) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003063108 |
| Entity Type | Organization |
| Organization Name | MEDICOS PAIN & SURGICAL SPECIALISTS, S.C. |
| Practice Address |
712 N Dearborn St Chicago IL 60654-3818 |
| Mailing Address |
4176 W Montrose Ave Chicago IL 60641-2161 |
| Practice Telephone | 7732833131 |
| Practice Fax Number | 7732833610 |
| Mailing Telephone | 7732833131 |
| Mailing Fax Number | 7732833610 |
| Enumeration Date | 2008-08-20 |
| Last Update Date | 2008-08-20 |
| Authorized Official Name | DR. DERRICK D. WALLERY (MANAGER) |
| Authorized Official Telephone | 7732833131 |
| Authorized Official Credential | D.C. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208VP0000X |
Pain Medicine Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians |
| Street Address |
712 N DEARBORN ST |
| City | CHICAGO |
| State | IL |
| Zip Code | 60654-3818 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821191404 | Gary G Wiesman | Otolaryngology | 712 N Dearborn St, Chicago, IL 60654-3846 | 2006-09-07 |
| 1033754320 | Audrey R Snyder | Physician Assistant | 712 N Dearborn St, Chicago, IL 60654-3846 | 2019-11-11 |
| 1134777311 | Iv Solution & Infusion Centers, LLC | Anesthesiology | 712 N Dearborn St, Chicago, IL 60654-3846 | 2019-08-30 |
| 1073080909 | Kierra La Shawn Bruno-rodgers | Orthopaedic Surgery | 712 N Dearborn St, Chicago, IL 60654-3846 | 2018-10-29 |
| 1609375021 | Kelly Diamond | Physician Assistant | 712 N Dearborn St, Chicago, IL 60654-3846 | 2018-02-12 |
| 1578096749 | Midwest Specialty Pharmacy LLC | Pharmacy | 712 N Dearborn St, Ste. 3a, Chicago, IL 60654-3846 | 2017-04-05 |
| 1700246592 | Anesthesia Associates of Chicago Inc | Anesthesiology | 712 N Dearborn St, Chicago, IL 60654-3846 | 2016-03-07 |
| 1891104246 | New Focus Medicine LLC | Clinic/Center | 712 N Dearborn St, Chicago, IL 60654-3846 | 2014-08-11 |
| 1659700151 | Brittany Macleod | Physician Assistant | 712 N Dearborn St, Chicago, IL 60654-3846 | 2013-11-05 |
| 1831527290 | Ora Dental Group, LLC | Dentist | 712 N Dearborn St, 4th Floor, Chicago, IL 60654-3846 | 2013-10-23 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912523564 | Male-order Men's Health LLC | Pharmacy | 710 N. Dearborn St., Chicago, IL 60654 | 2020-06-19 |
| 1669014924 | Tanner John Magee | Chiropractor | 415 N. Lasalle St., Suite 605, Chicago, IL 60654 | 2019-10-08 |
| 1144873886 | Fraeda Friedman | Social Worker | 451 N Lasalle Dr, Chicago, IL 60654 | 2019-07-22 |
| 1568024040 | Robin Elizabeth Miller | Dietitian, Registered | 770 North Lasalle Street, Suite 800, Chicago, IL 60654 | 2019-07-03 |
| 1487115804 | Ontario Street Operatory Fac | Clinic/Center | 22 W Ontario Street Operatory, Chicago, IL 60654 | 2019-03-28 |
| 1134697683 | Ghazal Kermani | Dentist | 350 North Clark Street, Suite 600, Chicago, IL 60654 | 2018-11-02 |
| 1225516842 | Tyler Jonathan Hinkel | Radiology | 33 W Ontario St Apt 46f, Chicago, IL 60654 | 2018-08-06 |
| 1710495312 | Mia Zarlengo | Dietitian, Registered | 770 N Lasalle Dr, 800, Chicago, IL 60654 | 2018-01-17 |
| 1568970341 | Kelly Lyons | Acupuncturist | 770 N Lasalle St., Suite 800, Chicago, IL 60654 | 2018-01-16 |
| 1407367568 | Amy Mcnicholas | Counselor | 721 N Lasalle, Chicago, IL 60654 | 2017-10-17 |
| Find all providers in zip 60654 | ||||
| Taxonomy Code | 208VP0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pain Medicine |
| Specialization | Pain Medicine |
| Pain Medicine is a primary medical specialty based on a distinct body of knowledge and a well-defined scope of clinical practice that is founded on science, research and education. It is concerned with the study of pain, the prevention of pain, and the evaluation, treatment, and rehabilitation of persons in pain. A comprehensive evaluation incorporates the physical, psychological, cognitive and socio-cultural contributions to pain. The treatment protocol may include pharmacological, invasive, behavioral, cognitive, rehabilitative and complementary strategies provided in a concurrent focused and patient specific manner. The pain medicine physician often serves the patient as a frontline physician regarding their pain, but also may serve as a consultant to other physicians, direct an interdisciplinary/multidisciplinary treatment team, conduct research, or advocate for the patient’s pain care with public and private agencies. The Pain Medicine physician may work in variety of settings including office, clinic, hospital, university, or governmental/public agencies. |
| Notes: Source: American Academy of Pain Medicine, www.painmed.org - Additional Resources:The American Board of Pain Medicine provides Board Certification. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588772255 | Health Benefits Physicians Services LLC | Pain Medicine | 25 E Washington Blvd, #1329, Chicago, IL 60602 | 2006-08-25 |
| 1871522631 | Midwest Physician Pain Center | Pain Medicine | 3522 E 95th St, Chicago, IL 60617-5164 | 2006-07-02 |
| 1427412410 | Integrated Pain Management-south Shore | Pain Medicine | 7141 S. Jeffery Blvd, Chicago, IL 60649-2425 | 2016-04-06 |
| 1174992119 | Midwest Pain Specialists Sc | Pain Medicine | 3139 W 111th St, Chicago, IL 60655-2205 | 2015-09-21 |
| 1831435544 | Pain Treatment Center of Chicago | Pain Medicine | 2004 N Pulaski Rd, Chicago, IL 60639-3767 | 2012-12-27 |
| 1841556792 | Hannah Chung | Pain Medicine | 1740 W Taylor St, Chicago, IL 60612-7232 | 2012-04-04 |
| 1386948321 | Elite Pain Ltd | Pain Medicine | 8630 S Pulaski Rd, Chicago, IL 60652-3633 | 2011-01-05 |
| 1376791236 | Medicos Healthcare Services Group, LLC | Pain Medicine | 1431 N Western Ave, Suite 208, Chicago, IL 60622-1797 | 2008-09-04 |
| 1487855219 | Michael Mcnett Md Sc | Pain Medicine | 4332 N Elston Ave, Chicago, IL 60641-2144 | 2007-05-30 |
| 1467668426 | Illinois Pharmacy Management, LLC | Pain Medicine | 8725 W Higgins Rd, Suite 485, Chicago, IL 60631-2716 | 2007-05-15 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.