Healthcare Provider Details

I. General information

NPI: 1245223403
Provider Name (Legal Business Name): TALCOTT INTERNAL MEDICINE & CARDIOLOGY LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7447 W TALCOTT AVE SUITE 262
CHICAGO IL
60631-3745
US

IV. Provider business mailing address

7447 W TALCOTT AVE SUITE 262
CHICAGO IL
60631-3745
US

V. Phone/Fax

Practice location:
  • Phone: 773-775-1900
  • Fax: 773-775-8034
Mailing address:
  • Phone: 773-775-1900
  • Fax: 773-775-8034

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateIL

VIII. Authorized Official

Name: CASIMIR E LIPINSKI
Title or Position: PRESIDENT
Credential: MD
Phone: 773-775-1900