Provider Demographics
NPI:1932279031
Name:GINSBURG, BETH (MD)
Entity Type:Individual
Prefix:DR
First Name:BETH
Middle Name:
Last Name:GINSBURG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:BETH
Other - Middle Name:
Other - Last Name:LURIE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:7607 MADISON ST
Mailing Address - Street 2:
Mailing Address - City:FOREST PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60130-3513
Mailing Address - Country:US
Mailing Address - Phone:708-450-4557
Mailing Address - Fax:708-338-0200
Practice Address - Street 1:7607 MADISON ST
Practice Address - Street 2:
Practice Address - City:FOREST PARK
Practice Address - State:IL
Practice Address - Zip Code:60130-3513
Practice Address - Country:US
Practice Address - Phone:708-450-4557
Practice Address - Fax:708-338-0200
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2012-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036078077207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL31601838OtherBLUE CROSS BLUE SHIELD
IL036078077Medicaid
IL202963OtherMEDICARE UNSPECIFIED
IL202964OtherMEDICARE UNSPECIFIED
IL036078077Medicaid
F43845Medicare UPIN