# INTERVENTIONAL PAIN MANAGEMENT OF NORTHERN ILLINOIS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255754362
- **Authorized official:** DR. ANDREW KONG D.C. (OWNER/PRESIDENT)
- **Authorized official phone:** (815) 316-0221

## Contact information

- **Practice address:** 4338 MORSAY DR, LOWER LEVEL, ROCKFORD, IL 61107-4877
- **Practice address phone:** (815) 397-8500
- **Practice address fax:** (815) 397-8588
- **Mailing address:** 4338 MORSAY DR, LOWER LEVEL, ROCKFORD, IL 61107-4877
- **Mailing address phone:** (815) 397-8500
- **Mailing address fax:** (815) 397-8588

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | — | IL | — |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | IL | Yes |

## Other

- **Enumeration date:** 01/24/2014
- **Last updated:** 04/07/2015