Provider Demographics
NPI:1811061146
Name:GALPERIN, TATYANA (MD)
Entity type:Individual
Prefix:
First Name:TATYANA
Middle Name:
Last Name:GALPERIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TATYANA
Other - Middle Name:
Other - Last Name:BAKHUR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:20570 N MILWAUKEE
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60015-3693
Mailing Address - Country:US
Mailing Address - Phone:847-215-9200
Mailing Address - Fax:847-215-9250
Practice Address - Street 1:20570 N MILWAUKEE
Practice Address - Street 2:
Practice Address - City:DEERFIELD
Practice Address - State:IL
Practice Address - Zip Code:60015-3693
Practice Address - Country:US
Practice Address - Phone:847-215-9200
Practice Address - Fax:847-215-9250
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL03609740GMedicaid
G78767Medicare UPIN
IL03609740GMedicaid