| NPI | 1255443222 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELTON WADE DIXON Owner/Physician 630-810-0451 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation Pain Medicine |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
| 2084P2900X Psychiatry & Neurology Pain Medicine | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2014-09-05 |