| NPI | 1487609202 |
|---|---|
| Former Legal Business Name | POPLAR CREEK CENTER FOR PAIN MANAGEMENT |
| Entity Type | Organization |
| Authorized Contact | EUGENE G LIPOV President 847-608-6620 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: IL 42617703) |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2020-08-22 |