MODERN PAIN CONSULTANTS (NPI# 1164451308) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164451308 |
| Entity Type | Organization |
| Organization Name | MODERN PAIN CONSULTANTS |
| Practice Address |
907 N Elm St Ste 101 Hinsdale IL 60521-3644 |
| Practice Telephone | 7084824500 |
| Practice Fax Number | 7084824502 |
| Mailing Telephone | 7084824500 |
| Mailing Fax Number | 7084824502 |
| Enumeration Date | 2006-07-01 |
| Last Update Date | 2020-06-29 |
| Authorized Official Name | GARY L KOEHN (PRESIDENT) |
| Authorized Official Telephone | 7084824500 |
| Authorized Official Credential | MD,PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208VP0000X |
Pain Medicine Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians | ||
| Y | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | US DEPT LABOR | 132321800 | 01 |
| IL | MEDICARE RAILROAD | 050054545 | 01 |
| IL | BLUE CROSS GRP ILLINOIS | 01608719 | 01 |
| IL | MEDICARE RAILROAD | 720000088 | 01 |
| IL | MEDICARE RAILROAD | 050054546 | 01 |
| IL | MEDICARE RAILROAD | 720000089 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093330516 | Modern Pain Consultants | Anesthesiology | 1802 N Division St Ste 605, Morris, IL 60450-3133 | 2020-06-10 |
| 1255956777 | Modern Pain Consultants | Anesthesiology | 1890 Silver Cross Blvd Ste 315, New Lenox, IL 60451-9605 | 2020-06-10 |
| Street Address |
907 N ELM ST STE 101 |
| City | HINSDALE |
| State | IL |
| Zip Code | 60521-3644 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457966079 | Alla Dubenets | Nurse Practitioner | 907 N Elm St Ste 101, Hinsdale, IL 60521-3644 | 2020-09-10 |
| 1780214718 | Suman Gowda Shaw | Nurse Practitioner | 907 N Elm St Ste 101, Hinsdale, IL 60521-3644 | 2020-01-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386256170 | Infinity Yoga LLC | Counselor | 702 Mills St, Hinsdale, IL 60521 | 2020-08-21 |
| 1427696855 | Anne Didier | Nurse Practitioner | 40 South Clay St., Suite 200, West Building, Hinsdale, IL 60521 | 2019-12-16 |
| 1619469244 | Rush Oak Brook Surgery Center, LLC | Clinic/Center | 2011 York Road, Suite 3000, Oak Brook, IL 60521 | 2018-05-30 |
| 1639680275 | Kelly M Lyell | Psychologist | 950 S Oak St, Hinsdale, IL 60521 | 2017-10-23 |
| 1386169720 | Elizabeth Ann Thorsness | Counselor | 412 East Fourth St., Hinsdale, IL 60521 | 2017-08-07 |
| 1275057424 | Bryndal Nicole Chervinko | Audiologist | 908 North Elm Street, Suite 306, Hinsdale, IL 60521 | 2017-07-31 |
| 1972038990 | Carolyn M Ball | Counselor | 19 N Grant St Ste 2c, Hinsdale, IL 60521 | 2017-04-27 |
| 1710429964 | Smiling Star Speech & Language | Speech-Language Pathologist | 120 E Odgen Avenue, Suite 110, Hinsdale, IL 60521 | 2016-11-04 |
| 1972964773 | Sharon Grob Murphy | Psychologist | 728 S. Park Ave., Hinsdale, IL 60521 | 2016-03-08 |
| 1992187074 | Matthew Destefani | Emergency Medicine | 109 Symonds Dr # 578, Hinsdale, IL 60521 | 2015-06-24 |
| Find all providers in zip 60521 | ||||
| Taxonomy Code | 208VP0014X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pain Medicine |
| Specialization | Interventional Pain Medicine |
| Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295365005 | Interventional Pain Consultants LLC | Pain Medicine | 4972 Benchmark Centre Dr Ste 400, Swansea, IL 62226-2070 | 2020-01-21 |
| 1922588110 | Pain Specialists of Greater Chicago S C | Pain Medicine | 15300 West Ave Ste C213, Orland Park, IL 60462 | 2018-08-16 |
| 1164940813 | Leonard Cerullo, Md, Ltd | Pain Medicine | 680 N Lake Shore Dr Ste 1428, Chicago, IL 60611-3461 | 2017-09-01 |
| 1417472887 | Kimberly Lynch | Pain Medicine | 5801 S Ellis Ave, Chicago, IL 60637-5418 | 2017-08-07 |
| 1598033953 | Manuel P. Blas | Pain Medicine | 1103 Berkley Ln, Lemont, IL 60439-8940 | 2011-12-13 |
| 1538356233 | Lake Shore Therapy Center, Inc. | Pain Medicine | 2338 W Morse Ave, 1 A, Chicago, IL 60645-4767 | 2007-09-27 |
| 1295811479 | Illinois Pain Treatment Institute, Ltd | Pain Medicine | 431 Summit, Elgin, IL 60120 | 2006-10-31 |
| 1164519005 | Wayne David Kelly | Pain Medicine | 1883 Hicks Rd, Suite A, Rolling Meadows, IL 60008-1254 | 2006-10-10 |
| 1417060146 | Ramesh Bathina | Pain Medicine | 1315 N Highland Ave # 105, Aurora, IL 60506-1400 | 2006-08-16 |
| 1457375115 | Terri L Dallas-prunskis | Pain Medicine | 4309 Medical Center Dr, B103, Mchenry, IL 60050 | 2006-07-26 |
| Find all providers with the same taxonomy | ||||
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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.