Provider Demographics
NPI:1194908863
Name:ACMI PAIN CARE LLC
Entity type:Organization
Organization Name:ACMI PAIN CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:VIKRAM
Authorized Official - Middle Name:B
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-426-7516
Mailing Address - Street 1:PO BOX 1053
Mailing Address - Street 2:
Mailing Address - City:BEDFORD PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60499-1053
Mailing Address - Country:US
Mailing Address - Phone:727-823-2188
Mailing Address - Fax:
Practice Address - Street 1:1479 COMMERCE DR
Practice Address - Street 2:
Practice Address - City:ALGONQUIN
Practice Address - State:IL
Practice Address - Zip Code:60102-5916
Practice Address - Country:US
Practice Address - Phone:847-426-7516
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-17
Last Update Date:2009-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036099069207L00000X
IL'036099069208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL05632292OtherBLUE CROSS BLUE SHIELD IL
613207400OtherUS DEPT OF LABOR
IL216217Medicare PIN