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General NPI Number Information
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NPI Number | 1396426359
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Entity Type | Organization
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Legal Business Name | LIPOV MEDICAL SC
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Dates
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Enumeration Date | 07/31/2023
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Last Update Date | 07/09/2025
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Provider Practice Location Address
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Address Line | 1 E OAKHILL DR STE 100
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City | WESTMONT
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State | IL
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Zip | 60559-5540
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Country | US
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Telephone | 937-838-0568
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Fax |
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Provider Business Mailing Address
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Address Line | 1 E OAKHILL DR STE 100
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City | WESTMONT
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State | IL
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Zip | 60559-5540
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Country | US
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Telephone | 937-838-0568
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. EUGENE LIPOV
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Credential | MD
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Telephone | 312-618-0829
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 364SP0808X
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Taxonomy Name | Psychiatric/Mental Health Clinical Nurse Specialist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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