Provider Demographics
NPI:1790958064
Name:LIPNIK, ANDREW JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:JAMES
Last Name:LIPNIK
Suffix:
Gender:M
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:UI HOSPITAL
Mailing Address - Street 2:1740 W. TAYLOR STREET, M/C 931
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-0001
Mailing Address - Country:US
Mailing Address - Phone:615-322-4916
Mailing Address - Fax:
Practice Address - Street 1:UI HOSPITAL
Practice Address - Street 2:1740 W. TAYLOR STREET, M/C 931
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-6061
Practice Address - Country:US
Practice Address - Phone:312-996-0241
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-08
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD503462085R0202X
TN503462085R0204X
NY2606102085R0204X
IL036.1200542085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology