Interventional Pain Management Of Northern Illinois
Anesthesiology, Pain Medicine in Rockford, IL. Organization (NPI-2).
NPI number1255754362
StatusActive
Last updated in NPPESApr 7, 2015
Details
- NPI
- 1255754362
- Entity type
- Organization (NPI-2)
- Legal business name
- Interventional Pain Management Of Northern Illinois
- Organization subpart
- No
- Enumeration date
- Jan 24, 2014
- Last updated
- Apr 7, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207LP2900X | Anesthesiology, Pain Medicine | – | IL | Yes |
| 111N00000X | Chiropractor | – | IL |
Practice location
4338 Morsay DrLower Level
Rockford, IL 61107-4877
Phone 815-397-8500 · Fax 815-397-8588
Mailing address
4338 Morsay DrLower Level
Rockford, IL 61107-4877
Phone 815-397-8500 · Fax 815-397-8588
Authorized official
Andrew Kong
Owner/President
8153160221
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All 14 Pain Medicine (Anesthesiology) Physician providers in Rockford · All 5,035 providers in Rockford
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