Great River Pain Center LLC

Organization Pain Medicine Physician · NPI 1073865291

Great River Pain Center LLC provides Pain Medicine Physician services in Moline, Illinois. Licensed in Illinois. Registered with an NPI since 2012.

Licensed in: IL
In the registry since: 2012

What do these letters mean?

LLC — Limited liability company: A form of business registration, not a clinical qualification.

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Practice location Address checks out

1634 Avenue Of The Cities
Moline, IL 61265-4860 Not confirmed with CMS for 13 years — call before visiting
Phone: (309) 762-9711
Fax: (309) 762-9747

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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pain Medicine Physician (primary)	Taxonomy 208VP0000X · Licence 036118384 (IL)

Record details

NPI number	1073865291
Entity type	Organization (Type 2)
Organization subpart	No
Authorized official	Sanjay Sundar — Owner · (312) 613-9999
NPI enumerated	October 11, 2012
Last updated in NPPES	October 11, 2012
Mailing address	1634 Avenue Of The Cities, Moline, IL 61265-4860