Provider Demographics
NPI:1841207297
Name:LIPKE, HOWARD (PHD)
Entity Type:Individual
Prefix:
First Name:HOWARD
Middle Name:
Last Name:LIPKE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1078 PEAR TREE LN
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:IL
Mailing Address - Zip Code:60090-5719
Mailing Address - Country:US
Mailing Address - Phone:847-541-1491
Mailing Address - Fax:
Practice Address - Street 1:1078 PEAR TREE LN
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:IL
Practice Address - Zip Code:60090-5719
Practice Address - Country:US
Practice Address - Phone:847-541-1491
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0071002427103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical