Organization
INTERVENTIONAL PAIN MANAGEMENT OF NORTHERN ILLINOIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREW KONG D.C. (OWNER/PRESIDENT)
(815) 316-0221
Entity
Organization
Contact information
Practice address
4338 MORSAY DR, LOWER LEVEL, ROCKFORD, IL 61107-4877
(815) 397-8500
(815) 397-8588
Mailing address
4338 MORSAY DR, LOWER LEVEL, ROCKFORD, IL 61107-4877
(815) 397-8500
(815) 397-8588
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
IL
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
IL
Other
Enumeration date
01/24/2014
Last updated
04/07/2015
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