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General NPI Number Information
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NPI Number | 1174961114
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Entity Type | Organization
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Legal Business Name | LINCOLN BABIGUMIRA PAIN CLINIC. LTD
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Dates
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Enumeration Date | 06/12/2013
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Last Update Date | 01/24/2024
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Provider Practice Location Address
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Address Line | 600 N COURT SUITE 20
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City | PALATINE
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State | IL
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Zip | 60067
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Country | US
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Telephone | 504-782-4463
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Fax |
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Provider Business Mailing Address
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Address Line | 600 N COURT SUITE 20
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City | PALATINE
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State | IL
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Zip | 60067
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Country | US
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Telephone | 504-782-4463
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | DR. EDWARD BABIGUMIRA
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Credential | M.D.
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Telephone | 504-782-4463
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | 036.132334
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License Number State | IL
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