| Midwest Academy Of Pain & Spine Inc | |
|
2867 Ogden Ave Lisle IL 60532-1634 | |
| (630) 420-8080 | |
| (630) 778-9090 |
| Full Name | Midwest Academy Of Pain & Spine Inc |
|---|---|
| Speciality | Anesthesiology |
| Location | 2867 Ogden Ave, Lisle, Illinois |
| Authorized Official Name and Position | Nesreen Suwan (OWNER / PHYSICIAN) |
| Authorized Official Contact | 6306704111 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Midwest Academy Of Pain & Spine Inc 2867 Ogden Ave Lisle IL 60532-1634 Ph: (630) 420-8080 | Midwest Academy Of Pain & Spine Inc 2867 Ogden Ave Lisle IL 60532-1634 Ph: (630) 420-8080 |
| NPI Number | 1083669477 |
|---|---|
| Provider Enumeration Date | 05/23/2006 |
| Last Update Date | 12/22/2022 |
| Certification Date | 12/22/2022 |
| Medicare PECOS PAC ID | 5395787212 |
|---|---|
| Medicare Enrollment ID | O20050601000425 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083669477 | NPI | - | NPPES |
| 036095342 | Medicaid | IL | |
| 0001635238 | Other | IL | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Secondary |
| 207LP2900X | Anesthesiology - Pain Medicine | (* (Not Available)) | Primary |
| Provider Name | Nesreen Suwan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1821095936 PECOS PAC ID: 1557303484 Enrollment ID: I20050602000219 |
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