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Organization

NAPERVILLE PAIN & REHABILITATION CLINIC, S.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
EDWARD KIM (EXECUTIVE DIRECTO)
(773) 816-0141
Entity
Organization

Contact information

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

Taxonomy

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

Other

Enumeration date
06/22/2011
Last updated
06/22/2011
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