| Internamed, P.c. | |
|
1975 Lin Lor Ln Suite 285 Elgin IL 60123-4902 | |
| (847) 608-7542 | |
| (847) 608-9812 |
| Full Name | Internamed, P.c. |
|---|---|
| Speciality | Internal Medicine |
| Location | 1975 Lin Lor Ln, Elgin, Illinois |
| Authorized Official Name and Position | Sergei G Lipov (PRESIDENT) |
| Authorized Official Contact | 8476087542 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Internamed, P.c. Po Box 5478 Elgin IL 60121-5478 Ph: (847) 608-7542 | Internamed, P.c. 1975 Lin Lor Ln Suite 285 Elgin IL 60123-4902 Ph: (847) 608-7542 |
| NPI Number | 1376573527 |
|---|---|
| Provider Enumeration Date | 07/04/2006 |
| Last Update Date | 02/23/2015 |
| Medicare PECOS PAC ID | 6305923681 |
|---|---|
| Medicare Enrollment ID | O20080410000625 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376573527 | NPI | - | NPPES |
| 036065857 | Medicaid | IL | |
| 0004527746 | Other | IL | BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 036065857 (Illinois) | Primary |
| Provider Name | Sergei G Lipov |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982634127 PECOS PAC ID: 1951488238 Enrollment ID: I20080410000616 |
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