MEDICARE: UPTOWN EMERGENCY PHYSICIANS, LLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	363A00000X	Physician Assistant
2	363L00000X	Nurse Practitioner
3	207P00000X	Emergency Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	000000613976	OTHER	IL	BLUE SHIELD

General Provider Information

NPI Number	:	1083852974
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UPTOWN EMERGENCY PHYSICIANS, LLP

Provider Business Mailing Address
First Line	:	200 CORPORATE BLVD
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70508-3870
Country	:	US
Telephone Number	:	800-893-9698
Fax Number	:

Provider Business Practice Location Address
First Line	:	17 GINGER CREEK MDWS
Second Line	:
City	:	GLEN CARBON
State	:	IL
Zip	:	62034-3508
Country	:	US
Telephone Number	:	618-656-9777
Fax Number	:

Authorized Official
Title or Position	:	LLP MANAGING PARTNER
Name	:	DR. CHRISTOPHER LIPSMEYER
Credential	:	MD
Telephone Number	:	800-893-9698

Provider Enumeration Date	:	01/30/2009
Last Update Date	:	05/10/2021

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