Southside Pain Relief Center Inc

Primary specialty

SpecialistTaxonomy code 174400000X

License

036105506 Issued in IL

Legal business name

SOUTHSIDE PAIN RELIEF CENTER INC

Practice address

5569 W 95TH St
Oak Lawn, IL 60453-2356

Phone

(708) 717-5947

Fax

(708) 576-8491

NPI assigned

May 28, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Tian Xia, D.O.

Title

President

Phone

(312) 953-9667

Specialties & licenses 1

Addresses

Other names 1

• Integrated Pain Management at Oak Lawn Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1401235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422576000000",
    "number": "1134531973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5569 W 95TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532356",
            "telephone_number": "708-717-5947",
            "fax_number": "708-576-8491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5569 W 95TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532356",
            "telephone_number": "708-717-5947",
            "fax_number": "708-576-8491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHSIDE PAIN RELIEF CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-28",
        "last_updated": "2015-01-30",
        "status": "A",
        "authorized_official_last_name": "XIA",
        "authorized_official_first_name": "TIAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "312-953-9667",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "IL",
            "license": "036105506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Integrated Pain Management at Oak Lawn",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kirsten Sorum, D.O.
• Sandra Soto
• Kimberly Souder, FNP
• Juanita R Soukouna, REGISTERED NURSE
• South Suburban Injury Care
• Southside Pain Relief Center Inc
• Southwest Allergy Associates.S.C.
• Southwest Center for Gastroenterology
• Southwest Chiropractic Rehabilitation Center LTD
• Southwest Foot Ankle, LLC

• Specialist in Oak Lawn, IL
• Providers in Oak Lawn, IL by specialty
• Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.