Organization
INTEGRATED PAIN MANAGEMENT, SC
Active
Parent organization
INTEGRATED PAIN MANAGEMENT, SC
Organization subpart
Yes
Provider details
NPI number
Legal business name
INTEGRATED PAIN MANAGEMENT, SC
Authorized official
TIAN XIA D.O. (OWNER)
(312) 842-4588
Entity
Organization
Contact information
Practice address
4906 N. WESTERN, CHICAGO, IL 60625-1922
(773) 334-3767
(312) 635-0108
Mailing address
244 E ROOSEVELT RD, LOMBARD, IL 60148-4647
(312) 842-4588
(312) 635-0108
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
036105506
IL
208VP0000X
Pain Medicine Physician
Primary
036105506
IL
332900000X
Non-Pharmacy Dispensing Site
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Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036105506
—
IL
Enumeration date
05/02/2018
Last updated
05/16/2024
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