MEDICARE: DR. NORBERT J KULPINSKI OD

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	046006749	IL

General Provider Information

NPI Number	:	1245227602
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NORBERT J KULPINSKI OD

Provider Business Mailing Address
First Line	:	304 N STATE ST
Second Line	:
City	:	BELVIDERE
State	:	IL
Zip	:	61008-3225
Country	:	US
Telephone Number	:	815-544-3431
Fax Number	:	815-544-6932

Provider Business Practice Location Address
First Line	:	304 N STATE ST
Second Line	:
City	:	BELVIDERE
State	:	IL
Zip	:	61008-3225
Country	:	US
Telephone Number	:	815-544-3431
Fax Number	:	815-544-6932

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/30/2005
Last Update Date	:	08/12/2008

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