| NPI | 1457035511 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDOLPH Y. CHANG Cmo 773-398-7791 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine |
| Additional Taxonomies | 208VP0014X Pain Medicine Interventional Pain Medicine |
| 261QP3300X Clinic/Center Pain | |
| Enumeration Date | 2023-06-09 |
| Last Update Date | 2023-06-09 |