NPIMap

Organization Active NPI

Integrated Pain Management (Berwyn) LTD

  • Specialist
  • Berwyn, IL
National Provider Identifier
1477974574
Registry record updated Dec 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
036105506 Issued in IL
Legal business name
INTEGRATED PAIN MANAGEMENT (BERWYN) LTD
Practice address
3253 Harlem Ave
Unit 5
Berwyn, IL 60402-2996
Phone
(630) 629-6298
Fax
(630) 495-7255
NPI assigned
Dec 17, 2013
Last updated
Dec 17, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2013

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

Authorized official

Name
Tian Xia, D.O.NPI 1467492728
Title
President
Phone
(773) 235-8000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X 036105506 IL Primary

Addresses

Primary practice location

3253 Harlem Ave
Unit 5
Berwyn, IL 60402-2996

Mailing address

3253 Harlem Ave
Unit 5
Berwyn, IL 60402-2996
Phone (773) 235-8000

National Provider Directory

National Provider Directory

Locations

3253 S Harlem Ave
Unit 5
Berwyn, IL 60402
Phone (630) 629-6298

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1387238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387238400000",
    "number": "1477974574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3253 HARLEM AVE",
            "address_2": "UNIT 5",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604022996",
            "telephone_number": "773-235-8000",
            "fax_number": "773-235-7018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3253 HARLEM AVE",
            "address_2": "UNIT 5",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604022996",
            "telephone_number": "630-629-6298",
            "fax_number": "630-495-7255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED PAIN MANAGEMENT (BERWYN) LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-17",
        "last_updated": "2013-12-17",
        "status": "A",
        "authorized_official_last_name": "XIA",
        "authorized_official_first_name": "TIAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-235-8000",
        "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": []
}

Other providers in Berwyn, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2013; 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.