| NPI | 1053901314 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACK DILLON Executive Director 312-505-1033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine |
| 208VP0000X Pain Medicine, Pain Medicine | |
| Enumeration Date | 2021-01-21 |
| Last Update Date | 2021-12-09 |