| NPI | 1649640822 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL J BORMAN Owner/Physician 847-894-1127 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME124453) |
| Enumeration Date | 2015-10-01 |
| Last Update Date | 2015-10-01 |