Provider Demographics
NPI:1073655601
Name:GAPINSKI, MARK A (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:A
Last Name:GAPINSKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:567 HILLSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:GLEN ELLYN
Mailing Address - State:IL
Mailing Address - Zip Code:60137-4679
Mailing Address - Country:US
Mailing Address - Phone:630-462-4963
Mailing Address - Fax:630-790-1495
Practice Address - Street 1:25 N WINFIELD RD
Practice Address - Street 2:SUITE 511
Practice Address - City:WINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60190-1222
Practice Address - Country:US
Practice Address - Phone:630-462-4963
Practice Address - Fax:630-462-0635
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL02233162OtherBCBS OF IL
K36677Medicare PIN
ILH65668Medicare UPIN
IL02233162OtherBCBS OF IL