| NPI | 1114266749 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL L GONION Credentialing 847-615-2200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: IA 34558) |
| Additional Taxonomies | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: IA 34558) |
| Enumeration Date | 2013-02-01 |
| Last Update Date | 2013-02-01 |