Provider Demographics
NPI:1740467729
Name:M.GALPERIN & T. GALPERIN, MD PC
Entity type:Organization
Organization Name:M.GALPERIN & T. GALPERIN, MD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MIKHAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:GALPERIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-215-9200
Mailing Address - Street 1:20570 N.MILWAUKEE AVE
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60015
Mailing Address - Country:US
Mailing Address - Phone:847-215-9200
Mailing Address - Fax:847-215-9250
Practice Address - Street 1:20570 N.MILWAUKEE AVE
Practice Address - Street 2:
Practice Address - City:DEERFIELD
Practice Address - State:IL
Practice Address - Zip Code:60015
Practice Address - Country:US
Practice Address - Phone:847-215-9200
Practice Address - Fax:847-215-9250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-22
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036097409Medicaid