Provider Demographics
NPI:1154529444
Name:HILPIPRE, NICHOLAS L (MD)
Entity type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:L
Last Name:HILPIPRE
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 1:4200 UNIVERSITY AVE
Mailing Address - Street 2:STE 104
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-5945
Mailing Address - Country:US
Mailing Address - Phone:515-226-2122
Mailing Address - Fax:
Practice Address - Street 1:12368 STRATFORD DR STE 300
Practice Address - Street 2:
Practice Address - City:CLIVE
Practice Address - State:IA
Practice Address - Zip Code:50325-8149
Practice Address - Country:US
Practice Address - Phone:515-226-9810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-07
Last Update Date:2020-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.1280712085P0229X
CO461332085R0202X
IA404132085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085P0229XAllopathic & Osteopathic PhysiciansRadiologyPediatric Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036128071Medicaid
IL036128071Medicaid