Provider Demographics
NPI:1245227602
Name:KULPINSKI, NORBERT J (OD)
Entity Type:Individual
Prefix:DR
First Name:NORBERT
Middle Name:J
Last Name:KULPINSKI
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 N STATE ST
Mailing Address - Street 2:
Mailing Address - City:BELVIDERE
Mailing Address - State:IL
Mailing Address - Zip Code:61008-3225
Mailing Address - Country:US
Mailing Address - Phone:815-544-3431
Mailing Address - Fax:815-544-6932
Practice Address - Street 1:304 N STATE ST
Practice Address - Street 2:
Practice Address - City:BELVIDERE
Practice Address - State:IL
Practice Address - Zip Code:61008-3225
Practice Address - Country:US
Practice Address - Phone:815-544-3431
Practice Address - Fax:815-544-6932
Is Sole Proprietor?:No
Enumeration Date:2005-09-30
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046006749152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK00517Medicare PIN
IL0792460001Medicare PIN