Individual
RENLIN XIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3412 W FULLERTON AVE, CHICAGO, IL 60647-2416
(773) 235-8000
Mailing address
PO BOX 478499, CHICAGO, IL 60647-8499
(773) 235-8000
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
036088691
IL
207R00000X
Internal Medicine Physician
036088691
IL
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
036088691
IL
208VP0000X
Pain Medicine Physician
Primary
036088691
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01620404
BC
IL
01
—
01633171
BC FOR LX HEALTH
IL
01
—
01635426
BCBS ID#
IL
05
—
036088691 4
—
IL
Enumeration date
03/16/2007
Last updated
07/24/2007
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