| NPI | 1679878698 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HONGKAI KEVIN DU President/Owner 618-767-3814 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: IL 036111184) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: IL 036111184) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: IL 36111184) | |
| 261QP3300X Clinic/Center, Pain (Licence: IL 036111184) | |
| Enumeration Date | 2011-01-22 |
| Last Update Date | 2023-01-30 |