Provider Demographics
NPI:1215251269
Name:COMPREHENSIVE PAIN SOLUTIONS
Entity type:Organization
Organization Name:COMPREHENSIVE PAIN SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SUNDAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-609-9836
Mailing Address - Street 1:3340 OAK PARK AVE
Mailing Address - Street 2:314
Mailing Address - City:BERWYN
Mailing Address - State:IL
Mailing Address - Zip Code:60402-3420
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3340 OAK PARK AVE
Practice Address - Street 2:314
Practice Address - City:BERWYN
Practice Address - State:IL
Practice Address - Zip Code:60402-3420
Practice Address - Country:US
Practice Address - Phone:309-973-4137
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-19
Last Update Date:2016-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036118384261QP3300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain