Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | IL |
NPI | 1013933118 |
---|---|
Provider Name | Dr. Julie Lipkin |
First Address | Chicago, IL 60625 |
Second Address | Chicago, IL 60612-3714 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D16404 | (02) | IL |