Provider Demographics
NPI:1013271618
Name:TAPON, PHILIPPE (MD)
Entity Type:Individual
Prefix:DR
First Name:PHILIPPE
Middle Name:
Last Name:TAPON
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 1:5113 S HARPER AVE STE 2C
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60615-4119
Mailing Address - Country:US
Mailing Address - Phone:312-820-4663
Mailing Address - Fax:312-586-7983
Practice Address - Street 1:5113 S HARPER AVE STE 2C
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60615-4119
Practice Address - Country:US
Practice Address - Phone:312-820-4663
Practice Address - Fax:312-586-7983
Is Sole Proprietor?:No
Enumeration Date:2012-06-27
Last Update Date:2023-02-02
Deactivation Date:2023-01-25
Deactivation Code:
Reactivation Date:2023-02-01
Provider Licenses
StateLicense IDTaxonomies
IL0361364922084P0800X, 2084P0800X
IL336.0978182084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILPENDINGMedicaid
ILPENDINGMedicare Oscar/Certification