Organization
ADVANCED INTERVENTIONAL SPINE AND PAIN INSTITUTE. LLC
Active
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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