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NPI Code Detail

MEDICARE: GARY LIPINSKI M.D.

MEDICARE: GARY LIPINSKI M.D.
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
1207Q00000XFamily Medicine Physician036059946IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
22215159OTHERILBLUE SHIELD GROUP #

General Provider Information

NPI Number : 1275543696
Entity Type Code : Individual
Provider Name (Legal Business Name) : GARY LIPINSKI M.D.
Provider Business Mailing Address
First Line : 213 E CASS ST
Second Line :
City : JOLIET
State : IL
Zip : 60432-2812
Country : US
Telephone Number : 815-726-3377
Fax Number :
Provider Business Practice Location Address
First Line : 213 E CASS ST
Second Line :
City : JOLIET
State : IL
Zip : 60432-2812
Country : US
Telephone Number : 815-726-3377
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2006
Last Update Date : 02/25/2025

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Directions to “ GARY LIPINSKI M.D.” Practice Location

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