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1003063108
MEDICOS PAIN & SURGICAL SPECIALISTS, S.C.
CHICAGO, IL
NPI
1003063108
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Entity Type
Organization
Authorized Contact
DERRICK D. WALLERY
Manager
773-283-3131
Organization Subpart ?
No
Primary Taxonomy
208VP0000X Pain Medicine, Pain Medicine
Enumeration Date
2008-08-20
Last Update Date
2008-08-20
Business Address
MEDICOS PAIN & SURGICAL SPECIALISTS, S.C.
712 N DEARBORN ST
CHICAGO, IL 60654-3818
Phone number: 773-283-3131
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Mailing Address
MEDICOS PAIN & SURGICAL SPECIALISTS, S.C.
4176 W MONTROSE AVE
CHICAGO, IL 60641-2161
Phone number: 773-283-3131
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