Organization
GUARDIAN INTERVENTIONAL PAIN MANAGEMENT INSTITUTE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOHAMED EL-ANSARY M.D. (OWNER)
(217) 274-9720
Entity
Organization
Contact information
Practice address
2203 EASTLAND DR STE 7, BLOOMINGTON, IL 61704-7924
(309) 808-1700
Mailing address
PO BOX 570, LAKE FOREST, IL 60045-0570
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
—
Other
Enumeration date
06/12/2017
Last updated
06/12/2017
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