Provider Demographics
NPI:1184711467
Name:LIPMAN, LAURIE S (MD)
Entity type:Individual
Prefix:DR
First Name:LAURIE
Middle Name:S
Last Name:LIPMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 E HURON ST
Mailing Address - Street 2:JBVA CHICAGO-LAKESIDE, PSYCHIATRY DEPT., RM 158C
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-3004
Mailing Address - Country:US
Mailing Address - Phone:312-469-3763
Mailing Address - Fax:
Practice Address - Street 1:333 E HURON ST
Practice Address - Street 2:JB VA CHICAGO-LAKESIDE, PSYCHIATRY DEPT., RM 158C
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-3004
Practice Address - Country:US
Practice Address - Phone:312-469-3763
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry