Provider Demographics
NPI:1487657078
Name:LIPINSKA, MARZENA (MD)
Entity Type:Individual
Prefix:
First Name:MARZENA
Middle Name:
Last Name:LIPINSKA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7447 WEST TALCOTT AVE
Mailing Address - Street 2:STE 216
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60631-3713
Mailing Address - Country:US
Mailing Address - Phone:773-631-0566
Mailing Address - Fax:773-631-4436
Practice Address - Street 1:7447 W TALCOTT AVE STE 216
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60631-3713
Practice Address - Country:US
Practice Address - Phone:773-631-0566
Practice Address - Fax:774-631-4436
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036095721207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036095721Medicaid
ILG60638Medicare UPIN
IL745367Medicare ID - Type Unspecified