| NPI | 1255754362 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW KONG Owner/President 815-316-0221 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine |
| Additional Taxonomies | 111N00000X Chiropractor |
| Enumeration Date | 2014-01-24 |
| Last Update Date | 2015-04-07 |