LIBERTYVILLE OBGYN S.C. NPI 1578612677

NPI Information

  • NPI: 1578612677
  • Provider Name: LIBERTYVILLE OBGYN S.C.
  • Classification: Obstetrics & Gynecology - 207V00000X
  • Entity Type: Organization
  • Address: 890 GARFIELD AVE
    104
    LIBERTYVILLE, IL
    ZIP 60048
  • Phone: (847) 367-0022

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NPI Details

LIBERTYVILLE OBGYN S.C. is an obstetrics gynecology in Libertyville, IL. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. LIBERTYVILLE OBGYN S.C. NPI is 1578612677. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

890 GARFIELD AVE
104
LIBERTYVILLE, IL
ZIP 60048-723
Phone: (847) 367-0022
Fax: (847) 680-0696

The provider's authorized official is Vincenzo Padovano .
The authorized official title is President and has the following contact phone number (847) 367-0022.

The enumeration date for this NPI number is 1/9/2007 and was last updated on 2/13/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207V00000XObstetrics & Gynecology042617217ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1042617217OTHERILLINOISREGISTERED MEDICAL CORP
2=========MEDICAIDILLINOIS
304923732OTHERILLINOISBCBS
4F90379MEDICARE UPINILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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