| Great Lakes Pain & Treatment Centers, Ltd | |
|
2200 S Main St Suite 214 Lombard IL 60148-5334 | |
| (630) 364-4114 | |
| (866) 868-7320 |
| Full Name | Great Lakes Pain & Treatment Centers, Ltd |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 2200 S Main St, Lombard, Illinois |
| Authorized Official Name and Position | Jonathan I Wang (PRESIDENT) |
| Authorized Official Contact | 6303644114 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Great Lakes Pain & Treatment Centers, Ltd 2200 S Main St Suite 214 Lombard IL 60148-5334 Ph: (630) 364-4114 | Great Lakes Pain & Treatment Centers, Ltd 2200 S Main St Suite 214 Lombard IL 60148-5334 Ph: (630) 364-4114 |
| NPI Number | 1598916660 |
|---|---|
| Provider Enumeration Date | 10/07/2008 |
| Last Update Date | 10/07/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598916660 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 036-111890 (Illinois) | Primary |
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