IndividualActive
Boss Povieng, MD
NPI 1316569064 · Pain Medicine (Physical Medicine & Rehabilitation) Physician · Chicago, IL
Provider details
- NPI number
- 1316569064
- Entity type
- Individual
- Primary specialty
- Pain Medicine (Physical Medicine & Rehabilitation) PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- Yes
- License
- 036.168979 (IL)
Specialties & taxonomies
- Pain Medicine (Physical Medicine & Rehabilitation) PhysicianPrimary2081P2900XLicense 036.168979 (IL)
Allopathic & Osteopathic Physicians
Practice location
1620 W Harrison St Ste 403
Chicago, IL 60612-3801
Phone: (312) 942-7100
Approximate (ZIP-level) locationGet directions
Mailing address
1620 W Harrison St Ste 403
Chicago, IL 60612-3801
Registry dates
- Enumerated
- 2020-05-15
- Last updated
- 2024-06-26
- Certified
- 2024-06-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.