# CHICAGO PAIN AND REHABILITATION CLINIC P.C.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Chicago Pain and Rehabilitation Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154560530
- **Authorized official:** DR. DAVID YOUNG SIK KIM (MEDICAL DIRECTOR)
- **Authorized official phone:** (847) 763-8010

## Contact information

- **Practice address:** 7300 N CICERO AVE, LINCOLNWOOD, IL 60712-1641
- **Practice address phone:** (847) 763-8010
- **Mailing address:** 7300 N CICERO AVE, LINCOLNWOOD, IL 60712-1641

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225400000X | Rehabilitation Practitioner | — | IL | Yes |

## Other

- **Enumeration date:** 02/09/2009
- **Last updated:** 03/04/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 366760 | MEDICARE PTAN | — |