Provider Demographics
NPI:1548364714
Name:LAPIN, SANFORD L (MD)
Entity type:Individual
Prefix:DR
First Name:SANFORD
Middle Name:L
Last Name:LAPIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34121 EAGLE WAY
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60678-1341
Mailing Address - Country:US
Mailing Address - Phone:224-231-4363
Mailing Address - Fax:866-642-1525
Practice Address - Street 1:660 N WESTMORELAND RD
Practice Address - Street 2:
Practice Address - City:LAKE FOREST
Practice Address - State:IL
Practice Address - Zip Code:60045-1659
Practice Address - Country:US
Practice Address - Phone:847-535-6100
Practice Address - Fax:866-642-1525
Is Sole Proprietor?:No
Enumeration Date:2006-09-11
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY28967207L00000X, 208000000X
IL036078487207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64289671Medicaid
KY64289671Medicaid
ILF400229624Medicare UPIN
KY0215612Medicare ID - Type UnspecifiedINDIVIDUAL MEDICARE ID