MEDICARE: DR. JOHN SESSIONS LIPPINCOTT D.D.S.

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	1223G0001X	General Practice Dentistry		IL

General Provider Information

NPI Number	:	1245429299
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN SESSIONS LIPPINCOTT D.D.S.

Provider Business Mailing Address
First Line	:	1642 E 56TH ST
Second Line	:	#701
City	:	CHICAGO
State	:	IL
Zip	:	60637-1952
Country	:	US
Telephone Number	:	630-881-5533
Fax Number	:

Provider Business Practice Location Address
First Line	:	1642 E 56TH ST
Second Line	:	#701
City	:	CHICAGO
State	:	IL
Zip	:	60637-1952
Country	:	US
Telephone Number	:	630-881-5533
Fax Number	:

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

Provider Enumeration Date	:	10/16/2007
Last Update Date	:	10/16/2007

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