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General NPI Number Information
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NPI Number | 1205090578
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Entity Type | Organization
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Legal Business Name | HOLISTIC SCIENCE PAIN CLINIC LLC
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Dates
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Enumeration Date | 07/15/2008
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Last Update Date | 04/21/2010
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Provider Practice Location Address
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Address Line | 105 129TH INFANTRY DRIVE
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City | JOLIET
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State | IL
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Zip | 60435
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Country | US
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Telephone | 815-725-7200
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Fax |
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Provider Business Mailing Address
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Address Line | 105 129TH INFANTRY DRIVE
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City | JOLIET
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State | IL
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Zip | 60435
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Country | US
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Telephone | 815-725-7200
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ASAD AKRAM CHEEMA
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Credential | MD
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Telephone | 815-725-7200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 036107324
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 036107324
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License Number State | IL
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