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General NPI Number Information
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NPI Number | 1043223688
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Entity Type | Organization
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Legal Business Name | LX HEALTH ADVOCATE CENTER LTD
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Dates
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Enumeration Date | 08/14/2006
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Last Update Date | 01/03/2014
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Provider Practice Location Address
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Address Line | 4906 N WESTERN AVE
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City | CHICAGO
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State | IL
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Zip | 60625-1922
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Country | US
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Telephone | 773-334-3767
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Fax | 773-334-4931
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Provider Business Mailing Address
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Address Line | 4906 N WESTERN AVE
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City | CHICAGO
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State | IL
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Zip | 60625-1922
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Country | US
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Telephone | 773-334-3767
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Fax | 773-334-4931
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | MR. RENLIN XIA
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Credential | M.D.
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Telephone | 773-334-3767
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 038008583
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 036088691
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | 036088691
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036088691
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License Number State | IL
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