Provider Demographics
NPI:1598719783
Name:TAPIA, RIGOBERTO (MD)
Entity Type:Individual
Prefix:DR
First Name:RIGOBERTO
Middle Name:
Last Name:TAPIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7318 MADISON ST
Mailing Address - Street 2:SUITE #2
Mailing Address - City:FOREST PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60130-3100
Mailing Address - Country:US
Mailing Address - Phone:708-771-5490
Mailing Address - Fax:708-771-5491
Practice Address - Street 1:7318 MADISON ST
Practice Address - Street 2:SUITE #2
Practice Address - City:FOREST PARK
Practice Address - State:IL
Practice Address - Zip Code:60130-3100
Practice Address - Country:US
Practice Address - Phone:708-771-5490
Practice Address - Fax:708-771-5491
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-20
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036094129208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036094129Medicaid
14D0980011OtherCLIA
IL336-055280OtherCONTROLLED SUBSTANCE
ILBT5414836OtherDEA NUMBER