OrganizationActive
Medicos Pain & Surgical Specialists, S.c.
NPI 1003063108 · Pain Medicine Physician · Chicago, IL
Provider details
- NPI number
- 1003063108
- Entity type
- Organization
- Primary specialty
- Pain Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Derrick Wallery, Manager(773) 283-3131
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(87/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
712 N Dearborn St
Chicago, IL 60654-3818
Phone: (773) 283-3131
Fax: (773) 283-3610
Street-level locationGet directions
Mailing address
4176 W Montrose Ave
Chicago, IL 60641-2161
Registry dates
- Enumerated
- 2008-08-20
- Last updated
- 2008-08-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.