ILLINOIS REGIONAL PAIN INSTITUTE S.C. NPI 1952337453

NPI Information

ILLINOIS REGIONAL PAIN INSTITUTE, S.C. is a specialist in Peoria, IL. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. ILLINOIS REGIONAL PAIN INSTITUTE, S.C. NPI is 1952337453. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

5401 N KNOXVILLE AVE
SUITE #416
PEORIA, IL
ZIP 61614-098
Phone: (309) 692-7246
Fax: (309) 692-7226

The provider's authorized official is Gayle Mucciante .
The authorized official title is Practice Administrator and has the following contact phone number (309) 692-7246.

The enumeration date for this NPI number is 6/25/2006 and was last updated on 1/3/2014.

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:

Other Identifiers

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

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