Provider Demographics
NPI:1861534877
Name:MARK A GAPINSKI MD SC
Entity type:Organization
Organization Name:MARK A GAPINSKI MD SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:A
Authorized Official - Last Name:GAPINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-462-4963
Mailing Address - Street 1:PO BOX 2607
Mailing Address - Street 2:
Mailing Address - City:GLEN ELLYN
Mailing Address - State:IL
Mailing Address - Zip Code:60138-2607
Mailing Address - Country:US
Mailing Address - Phone:630-462-4963
Mailing Address - Fax:630-462-0635
Practice Address - Street 1:25 N WINFIELD RD
Practice Address - Street 2:SUITE 511
Practice Address - City:WINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60190-1222
Practice Address - Country:US
Practice Address - Phone:630-462-4963
Practice Address - Fax:630-462-0635
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL02233162OtherBCBS PPO- IL
IL=========OtherTRICARE
IL214938Medicare PIN
IL02233162OtherBCBS PPO- IL