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 |