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General NPI Number Information
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NPI Number | 1457623787
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Entity Type | Organization
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Legal Business Name | JIN'S PAIN THERAPY CLINIC INC
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Dates
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Enumeration Date | 02/02/2012
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Last Update Date | 02/02/2012
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Provider Practice Location Address
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Address Line | 735 W. 35TH ST
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City | CHICAGO
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State | IL
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Zip | 60616
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Country | US
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Telephone | 773-386-2683
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Fax | 773-254-8944
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Provider Business Mailing Address
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Address Line | 735 W. 35TH ST
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City | CHICAGO
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State | IL
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Zip | 60616
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Country | US
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Telephone | 773-386-2683
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Fax | 773-254-8944
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Authorized Official
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Title or Position | NAPRAPATH
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Name | DR. BAILAN JIN
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Credential | D-N
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Telephone | 773-386-2683
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172P00000X
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Taxonomy Name | Naprapath
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License Number | 181-000303
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License Number State | IL
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