| NPI | 1124532593 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES R DIESFELD President 773-868-6824 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: IL 036.086023) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2017-11-21 |
| Last Update Date | 2020-07-09 |