Provider Demographics
NPI:1245223403
Name:TALCOTT INTERNAL MEDICINE & CARDIOLOGY LTD
Entity Type:Organization
Organization Name:TALCOTT INTERNAL MEDICINE & CARDIOLOGY LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CASIMIR
Authorized Official - Middle Name:E
Authorized Official - Last Name:LIPINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-775-1900
Mailing Address - Street 1:7447 W TALCOTT AVE
Mailing Address - Street 2:SUITE 262
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60631-3745
Mailing Address - Country:US
Mailing Address - Phone:773-775-1900
Mailing Address - Fax:773-775-8034
Practice Address - Street 1:7447 W TALCOTT AVE
Practice Address - Street 2:SUITE 262
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60631-3745
Practice Address - Country:US
Practice Address - Phone:773-775-1900
Practice Address - Fax:773-775-8034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
01607483OtherBS
ILCM3744Medicaid
01607483OtherBS