Provider Demographics
NPI:1356618037
Name:MARIA BAGINSKI M.D. LTD
Entity type:Organization
Organization Name:MARIA BAGINSKI M.D. LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:JANINA
Authorized Official - Last Name:BAGINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-685-8622
Mailing Address - Street 1:3929 N CENTRAL AVE STE 4
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60634-3072
Mailing Address - Country:US
Mailing Address - Phone:773-685-8622
Mailing Address - Fax:773-685-8980
Practice Address - Street 1:3929 N CENTRAL AVE STE 4
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60634-3072
Practice Address - Country:US
Practice Address - Phone:773-685-8622
Practice Address - Fax:773-685-8980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-22
Last Update Date:2012-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036086530207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILF69996Medicare UPIN