Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 036078640 | IL |
Y | 207XS0106X | Orthopaedic Hand Surgeon | 036078640 | IL |
NPI | 1205822921 |
---|---|
Provider Name | David J. Tulipan |
First Address | Chicago, IL 60674-3698 |
Second Address | Lombard, IL 60148-4932 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2005 |
Last Update Date | 14/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036078640 | (05) | IL |
200013546 | RAILROAD MEDICARE (01) | IL |
E17594 | (02) | IL |