Provider Demographics
NPI:1487609202
Name:ADVANCED PAIN CENTERS, S.C.
Entity type:Organization
Organization Name:ADVANCED PAIN CENTERS, S.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:G
Authorized Official - Last Name:LIPOV
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-608-6620
Mailing Address - Street 1:1800 MCDONOUGH RD
Mailing Address - Street 2:SUITE 221
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60192-4566
Mailing Address - Country:US
Mailing Address - Phone:847-608-6620
Mailing Address - Fax:847-742-5135
Practice Address - Street 1:1800 MCDONOUGH RD
Practice Address - Street 2:SUITE 221
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60192-4566
Practice Address - Country:US
Practice Address - Phone:847-608-6620
Practice Address - Fax:847-742-5135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL42617703208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL353435OtherELECTRONIC SUBMITTER ID
IL4478999OtherAETNA GROUP ID
IL1619628OtherBC/BS OF IL GROUP ID
IL4478999OtherAETNA GROUP ID
IL1619628OtherBC/BS OF IL GROUP ID
IL353435OtherELECTRONIC SUBMITTER ID
IL=========OtherTAX ID