Organization
INTEGRATED PAIN MANAGEMENT SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIAN XIA DO (OWNER)
(312) 842-4588
Entity
Organization
Contact information
Practice address
244 E ROOSEVELT RD, LOMBARD, IL 60148-4647
(312) 842-4588
(312) 635-0108
Mailing address
244 E ROOSEVELT RD, LOMBARD, IL 60148-4647
(312) 842-4588
(630) 599-7149
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
036-105506
IL
332900000X
Non-Pharmacy Dispensing Site
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036105506
—
IL
Enumeration date
06/07/2006
Last updated
05/16/2024
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