# NAPERVILLE PAIN & REHABILITATION CLINIC, S.C.

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

## Provider details

- **NPI number:** 1538455183
- **Authorized official:** EDWARD KIM (EXECUTIVE DIRECTO)
- **Authorized official phone:** (773) 816-0141

## Contact information

- **Practice address:** 1163 E OGDEN AVE, SUITE 505, NAPERVILLE, IL 60563-1687
- **Practice address phone:** (773) 816-0141
- **Mailing address:** 1163 E OGDEN AVE, SUITE 505, NAPERVILLE, IL 60563-1687

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | 036123576 | IL | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | 036123576 | IL | Yes |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | 036123576 | IL | — |

## Other

- **Enumeration date:** 06/22/2011
- **Last updated:** 06/22/2011