Illinois Regional Pain Institute, S.c.

NPI #1952337453 in Peoria, Illinois

Provider Information

NPI Number: 1952337453
Entity Type: Organization
Organization Name: Illinois Regional Pain Institute, S.c.
Primary Specialty: Specialist
Enumeration Date: Jun 25, 2006
Last Updated: Jan 3, 2014

Practice Location

Address: 5401 N KNOXVILLE AVE
Address 2: SUITE #416
City: Peoria
State: Illinois
ZIP Code: 61614-5098
Phone: (309) 692-7246

Authorized Official

Name: MS. GAYLE MUCCIANTE
Title: PRACTICE ADMINISTRATOR
Phone: (309) 692-7246

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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