| NPI | 1396426359 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EUGENE LIPOV President 312-618-0829 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine |
| Additional Taxonomies | 207L00000X Anesthesiology |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| 364SP0808X Clinical Nurse Specialist, Psych/Mental Health | |
| Enumeration Date | 2023-07-31 |
| Last Update Date | 2023-07-31 |