Healthcare Provider Details
I. General information
NPI: 1245689603
Provider Name (Legal Business Name): MORTA LAPKUS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/07/2016
Last Update Date: 01/15/2025
Certification Date: 01/15/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
120 SPALDING DR STE 205
NAPERVILLE IL
60540-6527
US
IV. Provider business mailing address
2650 RIDGE AVE STE 1223
EVANSTON IL
60201-1700
US
V. Phone/Fax
- Phone: 630-646-6020
- Fax: 630-527-3400
- Phone: 847-570-2040
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | 36159574 |
| License Number State | IL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: