Provider Demographics
NPI:1972014488
Name:BULINSKI, JOSEPH P (PA-C)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:P
Last Name:BULINSKI
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:JOE
Other - Middle Name:
Other - Last Name:BULINSKI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:1441 N 28TH ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62702-4420
Mailing Address - Country:US
Mailing Address - Phone:217-652-6649
Mailing Address - Fax:
Practice Address - Street 1:2300 N EDWARD ST
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:IL
Practice Address - Zip Code:62526-4163
Practice Address - Country:US
Practice Address - Phone:217-876-8121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-24
Last Update Date:2017-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085.006387363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant