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General NPI Number Information
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NPI Number | 1316804958
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Entity Type | Organization
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Legal Business Name | INTEGRATED PAIN MANAGEMENT, SC
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Dates
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Enumeration Date | 01/06/2026
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Last Update Date | 01/06/2026
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Provider Practice Location Address
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Address Line | 4749 LINCOLN MALL DR STE 525
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City | MATTESON
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State | IL
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Zip | 60443-2348
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Country | US
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Telephone | 312-842-4588
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Fax |
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Provider Business Mailing Address
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Address Line | 244 E ROOSEVELT RD STE 525
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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 |
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Authorized Official
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Title or Position | OWNER
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Name | TIAN XIA
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Credential | MD
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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