| NPI | 1497635221 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EUGENE LIPOV Owner 312-618-0829 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 207L00000X Anesthesiology |
| Enumeration Date | 2025-09-03 |
| Last Update Date | 2025-09-03 |