Organization
ADVANCED INTERVENTIONAL SPINE AND PAIN INSTITUTE. LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HONGKAI KEVIN DU M.D. (PRESIDENT/OWNER)
(618) 767-3814
Entity
Organization
Contact information
Practice address
4700 MEMORIAL DRIVE, SUITE 230 PAIN CENTER, 4700 MEMORIAL DRIVE, MEMORIAL HOSPITAL, BREESE, IL 62226
(618) 257-5902
(618) 257-6671
Mailing address
PO BOX 24001, BELLEVILLE, IL 62223-9001
(618) 767-3814
(618) 257-6671
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
036111184
IL
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
36111184
IL
208VP0014X
Interventional Pain Medicine Physician
Primary
036111184
IL
261QP3300X
Pain Clinic/Center
036111184
IL
Other
Enumeration date
01/22/2011
Last updated
01/30/2023
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