Healthcare Provider Details

I. General information

NPI: 1295077576
Provider Name (Legal Business Name): MARIA ANGELA LAPID MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2013
Last Update Date: 03/29/2022
Certification Date: 03/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1933 W GEORGE ST
CHICAGO IL
60657-4021
US

IV. Provider business mailing address

1933 W GEORGE ST
CHICAGO IL
60657-4021
US

V. Phone/Fax

Practice location:
  • Phone: 773-320-2041
  • Fax:
Mailing address:
  • Phone: 773-320-2041
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036.099867
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number036.099867
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: