CENTER FOR PAIN MANAGEMENT & REHAB S. C . NPI 1801061650

NPI Information

NPI: 1801061650
Provider Name: CENTER FOR PAIN MANAGEMENT & REHAB S. C .
Classification: Clinic/Center - 261QP3300X
Entity Type: Organization

Specialization: Pain

Address:
5401 N KNOXVILLE AVE
SUITE 117
PEORIA, IL
ZIP 61614
Phone: (309) 689-8888
Get Directions

CENTER FOR PAIN MANAGEMENT & REHAB S. C . is a pain clinic center in Peoria, IL. CENTER FOR PAIN MANAGEMENT & REHAB S. C . NPI is 1801061650. The provider is registered as an organization entity type.

The provider's business location address is:

5401 N KNOXVILLE AVE
SUITE 117
PEORIA, IL
ZIP 61614-095
Phone: (309) 689-8888
Fax: (309) 689-8410

The provider's authorized official is Yibing Li .
The authorized official title is President and has the following contact phone number (309) 696-3300.

The enumeration date for this NPI number is 4/23/2008 and was last updated on 11/6/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR0400X	Clinic/Center	Rehabilitation	036113585	ILLINOIS	No
2	261QP3300X	Clinic/Center	Pain	036113585	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	DN7761	OTHER		RR MEDICARE
2	216706	MEDICARE PIN	ILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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