Provider Demographics
NPI:1174961114
Name:LINCOLN BABIGUMIRA PAIN CLINIC. LTD
Entity type:Organization
Organization Name:LINCOLN BABIGUMIRA PAIN CLINIC. LTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:BABIGUMIRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-782-4463
Mailing Address - Street 1:600 N COURT
Mailing Address - Street 2:SUITE 20
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60067
Mailing Address - Country:US
Mailing Address - Phone:504-782-4463
Mailing Address - Fax:
Practice Address - Street 1:600 N COURT
Practice Address - Street 2:SUITE 20
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60067
Practice Address - Country:US
Practice Address - Phone:504-782-4463
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-12
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.132334208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty