| NPI | 1639467749 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IVAN KUKHAR Owner 773-470-9082 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: IL 036124664) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 036124664) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: IL 036124664) | |
| Enumeration Date | 2011-07-11 |
| Last Update Date | 2022-05-24 |