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General NPI Number Information
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NPI Number | 1184966822
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Entity Type | Organization
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Legal Business Name | INTEGRATED PAIN MANAGEMENT
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Dates
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Enumeration Date | 03/20/2013
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Last Update Date | 03/05/2025
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Provider Practice Location Address
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Address Line | 2502 N HARLEM AVE
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City | ELMWOOD PARK
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State | IL
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Zip | 60707-2020
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Country | US
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Telephone | 312-842-4588
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Fax | 630-495-7255
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Provider Business Mailing Address
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Address Line | 244 E ROOSEVELT RD
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City | LOMBARD
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State | IL
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Zip | 60148-4647
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Country | US
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Telephone | 312-842-4588
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Fax | 630-495-7255
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Authorized Official
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Title or Position | CEO
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Name | TIAN XIA
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Credential | D.O
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Telephone | 312-842-4588
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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