Organization
CENTER FOR PAIN MANAGEMENT & REHAB S. C .
Active
Organization
CENTER FOR PAIN MANAGEMENT & REHAB S. C .
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. YIBING LI MD (PRESIDENT)
(309) 696-3300
Entity
Organization
Contact information
Practice address
5401 N KNOXVILLE AVE, SUITE 117, PEORIA, IL 61614-5095
(309) 689-8888
(309) 689-8410
Mailing address
5401 N KNOXVILLE AVE, SUITE 117, PEORIA, IL 61614-5095
(309) 689-8888
(309) 689-8410
Taxonomy
Speciality
Code
Description
License number
State
261QP3300X
Pain Clinic/Center
Primary
036113585
IL
261QR0400X
Rehabilitation Clinic/Center
036113585
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DN7761
RR MEDICARE
—
Enumeration date
04/23/2008
Last updated
11/06/2015
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